Yang Y, et al. BMC Cardiovasc Disord. 2019 Nov 7;19(1):249.
Fluid overload and congestion are major causes for hospitalization in advanced heart failure (HF). Objective of conventional pharmacologic therapies like: Intravenous (IV) loop diuretics (LDs) aims to reduce fluid overload in advanced HF but have reported certain side effects. Early ultrafiltration (UF) is considered as second-line therapy only for patients with refractory congestion, who failed to respond to LD-based strategies. The early continuous ultrafiltration in Chinese patients with congestive heart failure (EUC-CHF) trial was an open-label, registry-based, prospective study was conducted on Chinese patients with congestive HF (EUC-CHF) for 24-months. The objective of the trial was to evaluate the efficacy and safety of early UF in patients with acute decompensated HF to reduce volume overload and improve clinical outcome. Forty patients were enrolled to two treatment groups (n = 20 for each group) (Figure 1). After baseline visit, follow-up visit will occur at the end of study treatment, 24 h, 48 h, and 72 h after the end of study treatment, at discharge, and 30 days after discharge. The primary outcomes of the trial were: The changes of weight loss and dyspnea severity score after treatment, and the occurrence of clinically overt major bleeding.
Figure 1: Study design. The control group will be treated with intravenous loop diuretics by experienced HF cardiologists according to guideline recommendations. Patients of the early UF group will receive a single or repeated session of UF started within 24 h from admission until the relief of patient’s symptom. HF, heart failure; UF, ultrafiltration
Thus, UC-CHF is one of the first controlled trials tailored to determine the benefit of UF with 24 h from hospital admission. The study evaluates the effectiveness and safety of selecting patients who are suitable and could benefit from early UF by certain risk factors to guide early UF treatment. The study also provides clinical evidence for early UF in Chinese patients with acute decompensated HF and may contribute to volume overload reduction and clinical outcome improvement in this population.
