[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"acute-heart-failure-ahf\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:acute-heart-failure-ahf":26},{"pageToken":4,"total":5,"offset":6,"count":7,"results":8},null,26,0,25,[9,41,70,98,126,153,179,210,234,262,296,325,355,373,400,427,459,487,517,542,567,591,619,645,669],{"id":10,"slug":11,"hasResults":12,"nctId":13,"briefTitle":14,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":19,"targetDuration":22,"studyType":23,"phases":4,"briefSummary":24,"conditions":25,"keywords":4,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":29,"lastUpdatePostDateStruct":30,"startDateStruct":33,"completionDateStruct":35,"leadSponsor":37,"locationsCount":40},"100645309","assessment-of-residual-congestion-in-acute-decompensated-heart-failure-100645309",false,"NCT07682298","Assessment of Residual Congestion in Acute Decompensated Heart Failure","VExUS-AHF","Inclusion Criteria:\n\n1. Adults (≥18 years) admitted with ADHF.\n2. Clinical evidence of congestion during admission, indicated by ≥1 of the following: pitting peripheral edema, ascites, elevated jugular venous pressure, or radiologic\u002Fultrasound evidence of pulmonary congestion.\n3. Treatment with ≥40 mg i.v. furosemide or equivalent dose loop diuretic during admission.\n\nExclusion Criteria:\n\n1. Pregnancy\n2. Moribund\n3. Solitary kidney\n4. Inability to provide written consent","ALL","18 Years",{"count":20,"type":21},580,"ESTIMATED","90 Days","OBSERVATIONAL","DESIGN:\n\nA prospective, multicenter, observational cohort study including 580 patients admitted for acute decompensated heart failure (ADHF).\n\nUltrasound assessment of congestion (VExUS and LUS) will be performed serially during admission: within 48 hours of admission, at the time diuretic therapy is switched from intravenous to oral, and on the day of discharge. The discharge assessment will serve as the primary predictor.\n\nTreating physicians will be blinded to all ultrasound findings. Patients will be followed for 90 days by telephone follow-up and chart review for the primary endpoint, with extended chart review at one year for selected secondary endpoints.\n\nAIMS:\n\nTo determine whether combined ultrasound assessment of venous (VExUS) and pulmonary congestion (LUS) at discharge predicts heart failure readmission and all-cause mortality in patients hospitalized with ADHF.\n\nHYPOTHESIS:\n\nAbnormal VExUS and\u002For LUS findings at discharge are associated with a higher risk of heart failure readmission and all-cause mortality after 90 days.\n\nPRIMARY ENDPOINT:\n\nThe primary endpoint is a composite of heart failure readmission and all-cause mortality (time-to-event analysis) after a 90-day period (chart review). Abnormal VExUS will be defined according to criteria from our ongoing validation study. Abnormal LUS is defined as ≥3 B-lines in ≥2 scanning zones per hemithorax (8-zone method) or ≥15 total B-lines overall.\n\nThe primary analysis will evaluate the association between discharge VExUS and LUS findings and the risk of 90-day heart failure readmission and all-cause mortality using Cox proportional hazards regression. Models will be adjusted for age, sex, and comorbidities.\n\nSECONDARY ENDPOINTS:\n\n1. DAOH within 90 days and one year after discharge\n2. All-cause mortality within 90 days and one year after discharge\n3. Rehospitalization for ADHF within 90 days and one year after discharge\n4. Association between discharge VExUS and markers of congestion, including objective markers (jugular venous pressure, peripheral edema, pulmonary rales, and weight change), NT-proBNP, renal function, and echocardiographic measures of cardiac function.\n5. Incremental prognostic value of discharge VExUS and LUS beyond standard clinical assessment of congestion (jugular venous pressure, peripheral edema, pulmonary rales, and weight change) for predicting 90-day and one-year heart-failure readmission and all-cause mortality.\n6. Post-discharge diuretic use, defined as the change in loop diuretic dose (furosemide-equivalent) from discharge to 30- and 90-day follow-up, and occurrence of diuretic intensification (dose increase or addition of thiazide-type diuretic) within 90 days.\n\nSecondary analyses will employ Cox models for time-to-event outcomes (readmission, mortality, diuretic intensification) and linear regression for continuous outcomes (DAOH, change in diuretic dose). The relationship between discharge VExUS\u002FLUS and post-discharge diuretic use will be evaluated both continuously (dose change) and categorically (intensification vs. no intensification). Incremental prognostic value beyond clinical and biochemical markers (e.g., NT-proBNP) will be assessed using nested model comparisons (likelihood ratio tests, AIC, C-index, NRI, IDI).\n\nINCLUSION CRITERIA:\n\n1. Adults (≥18 years) admitted with ADHF.\n2. Clinical evidence of congestion during admission, indicated by ≥1 of the following: pitting peripheral edema, ascites, elevated jugular venous pressure, or radiologic\u002Fultrasound evidence of pulmonary congestion.\n3. Treatment with ≥40 mg i.v. furosemide or equivalent dose loop diuretic during admission.\n\nEXCLUSION CRITERIA:\n\n1. Pregnancy\n2. Moribund\n3. Solitary kidney\n4. Inability to provide written consent",[26,27],"Acute Heart Failure (AHF)","Decompensated Chronic Heart Failure","RECRUITING","2026-06-26",{"date":31,"type":32},"2026-07-02","ACTUAL",{"date":34,"type":32},"2026-02-15",{"date":36,"type":21},"2028-11-01",{"name":38,"class":39},"Aarhus University Hospital","OTHER",3,{"id":42,"slug":43,"hasResults":12,"nctId":44,"briefTitle":45,"officialTitle":45,"acronym":46,"eligibilityCriteria":47,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":48,"targetDuration":4,"studyType":50,"phases":51,"briefSummary":53,"conditions":54,"keywords":55,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":60,"lastUpdatePostDateStruct":61,"startDateStruct":63,"completionDateStruct":65,"leadSponsor":67,"locationsCount":69},"100627495","evaluation-of-fibroscan-performance-in-diagnosing-acute-heart-failure-in-patients-presenting-to-the-emergency-department-100627495","NCT07449377","Evaluation of Fibroscan® Performance in Diagnosing Acute Heart Failure in Patients Presenting to the Emergency Department","FIBROSCAF","Inclusion Criteria:\n\n1. Patients ≥18 years\n2. ED patients presenting with acute dyspnea and absence of any other obvious cause of dyspnea (for example pneumothorax, acute pneumonia, acute coronary syndrome, Covid) …\n3. Social security affiliation (except AME)\n4. Informed consent signed\n\nExclusion Criteria:\n\n1. Known chronic liver disease, defined by a Prothrombic time of \\\u003C 50%, or any former diagnosis of liver fibrosis.\n2. No skin wounds in the abdominal area on which the Fibroscan® will be used\n3. History of liver transplantation\n4. eGFR \\\u003C30 mL\u002Fmin\n5. Patient under legal protection measure (tutorship or curatorship) and patient deprived of freedom\n6. Pregnancy and breastfeeding\n7. Participation in another interventional trial",{"count":49,"type":21},100,"INTERVENTIONAL",[52],"NA","Acute heart failure (AHF) is a major cause of acute dyspnea in emergency departments (EDs), driven primarily by venous congestion, which can lead to hepatic congestion and risk of subsequent liver dysfunction. Current diagnostic tools include clinical evaluation, biomarkers, and imaging (Chest X-Ray or echography), are often limited by delayed results, variability, and suboptimal accuracy in emergency settings.\n\nFibroscan®, a non-invasive device originally designed to assess liver stiffness in chronic liver conditions, has shown potential in detecting liver congestion linked to heart failure. Studies have highlighted significant correlations between liver stiffness measurements (LSM) and markers of venous congestion, such as central venous pressure and adverse outcomes in heart failure patients. Preliminary findings suggest that LSM could provide rapid, bedside insights into systemic congestion, offering a promising avenue for improving diagnostic workflows in acute care.\n\nWhile prior research has mainly focused on chronic heart failure or small study populations, further investigation is needed to explore the utility of Fibroscan® in acute presentations of AHF within EDs. This could help address the limitations of existing diagnostic approaches and enhance patient management in time-sensitive environments.",[26],[56,57,58,59],"Acute heart failure (AHF)","Acute dyspnea","liver stiffness","emergency department","2026-06-22",{"date":62,"type":32},"2026-06-25",{"date":64,"type":32},"2026-04-02",{"date":66,"type":21},"2026-11",{"name":68,"class":39},"Assistance Publique - Hôpitaux de Paris",1,{"id":71,"slug":72,"hasResults":12,"nctId":73,"briefTitle":74,"officialTitle":75,"acronym":76,"eligibilityCriteria":77,"healthyVolunteers":12,"sex":17,"minAge":78,"maxAge":4,"enrollmentInfo":79,"targetDuration":4,"studyType":23,"phases":4,"briefSummary":81,"conditions":82,"keywords":85,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":89,"lastUpdatePostDateStruct":90,"startDateStruct":92,"completionDateStruct":94,"leadSponsor":96,"locationsCount":69},"100633695","sarcopenia-in-older-patients-hospitalized-for-acute-heart-failure-100633695","NCT07530029","Sarcopenia in Older Patients Hospitalized for Acute Heart Failure.","Multimodal Approach to Sarcopenia and Its Prognostic Impact in Older Patients Hospitalized for Acute Heart Failure (MUSICA Study).","MUSICA","Inclusion Criteria:\n\n* Patients with HF-pEF (LVEF ≥50%), hospitalized for AHF, with signs of fluid overload and requiring intravenous diuretic treatment. The diagnosis of HF will be made in accordance with ESC-2021 guidelines based on the presence of typical signs and symptoms, elevated natriuretic peptides (BNP \\>100 pg\u002FmL or NTproBNP \\>300 pg\u002FmL), and evidence of underlying structural heart disease by transthoracic echocardiography (performed during admission or within a period of 24 months prior to admission).\n* Age ≥ 80 years.\n* NYHA functional class II-IV.\n\nExclusion Criteria:\n\n* End-of-life care.\n* Inability to comply with study procedures.\n* Already included patients on readmission.","80 Years",{"count":80,"type":21},110,"Acute heart failure (AHF) is the leading cause of hospitalization in people over 65, with the group with preserved ejection fraction (HFpEF) being the most closely related to aging. Among its comorbidities, sarcopenia stands out, and its assessment requires measurement of muscle mass. Muscle ultrasound is an accessible and economical alternative, although its prognostic value is still uncertain. The presence of common pathophysiological mechanisms between HF-PEF and sarcopenia leads to the study of biomarkers to improve their characterization.\n\nMultimodal characterization of sarcopenia, integrating muscle mass and strength with skeletal and cardiac muscle biomarkers, will improve prognostic stratification at discharge in elderly patients with HFpEF hospitalized for ACS. We seek to evaluate the prognostic value of muscle mass estimated by ultrasound, in combination with strength measurements and circulating biomarkers related to sarcopenia, as this could improve the prediction of clinical events after hospitalization for AHF in elderly patients with HFpEF. In addition, ultrasound estimation of muscle mass will be analyzed against BIA, the relationship between skeletal and cardiac muscle will be characterized, and the usefulness of the multimodal approach to sarcopenia will be evaluated.\n\nThis study is observational, prospective, and single-center. It will include 110 patients hospitalized for AHF aged ≥80 years. Events will be monitored for 6 months after discharge. Variables include clinical data, ultrasound data (lung, VExUS, and muscle mass), congestion markers (BNP, CA125), biomarkers (GDF-15, sST2, BDNF, and myostatin\u002Ffollistatin), bioimpedance, and dynamometry. Data will be analyzed using regression models and survival analysis to identify prognostic factors.\n\nThis study has the potential to improve the clinical management of patients with acute heart failure by providing key information on its interaction with sarcopenia. The results could help identify more effective strategies to reduce rehospitalization and mortality in these patients, improving their prognosis and quality of life.",[26,83,84],"Sarcopenia","Heart Failure",[26,83,86,87,88],"Point-of-care ultrasound (PoCUS)","Biomarkers","Heart Failure with Preserved Ejection Fraction","2026-06-18",{"date":91,"type":32},"2026-06-23",{"date":93,"type":32},"2026-05-05",{"date":95,"type":21},"2027-11",{"name":97,"class":39},"Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal",{"id":99,"slug":100,"hasResults":12,"nctId":101,"briefTitle":102,"officialTitle":103,"acronym":104,"eligibilityCriteria":105,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":106,"enrollmentInfo":107,"targetDuration":4,"studyType":50,"phases":109,"briefSummary":111,"conditions":112,"keywords":113,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":117,"lastUpdatePostDateStruct":118,"startDateStruct":120,"completionDateStruct":122,"leadSponsor":124,"locationsCount":69},"100617660","phase-4-digoxin-after-acute-heart-failure-dig-dica-100617660","NCT07321509","Digoxin After Acute Heart Failure (DIG-DICA)","Evaluation of Digoxin Therapy in Patients With Heart Failure After Acute Decompensation","DIG-DICA","Inclusion Criteria:\n\n1. Male or female ≥ 18 years of age who have signed written informed consent and are willing and able to complete treatment and follow-up.\n2. Recent hospitalization or emergency department visit for decompensated heart failure with reduced ejection fraction (HFrEF) (LVEF ≤ 40%).\n3. Resting heart rate ≥ 60 bpm in patients without a pacemaker.\n4. Distance walked on the 6-minute walk test (6MWT) ≤ 450 meters and\u002For less than 80% of the predicted value.\n5. NT-proBNP ≥ 450 pg\u002FmL, or ≥ 900 pg\u002FmL in patients with atrial fibrillation, and\u002For echocardiographic criteria of congestion\n\n   \\-\n\nExclusion Criteria:\n\n1. Resting heart rate \\\u003C 60 bpm in sinus rhythm or \\\u003C 70 bpm in atrial fibrillation.\n2. Myocardial infarction, acute coronary syndrome, myocarditis, percutaneous coronary intervention, or recent implantation (within the past 3 months) of cardiac resynchronization therapy (CRT), pacemaker, or implantable cardioverter-defibrillator (ICD); cardiac surgery or stroke within the past 30 days.\n3. Estimated glomerular filtration rate (eGFR) ≤ 30 mL\u002Fmin\u002F1.73 m² (based on a sample obtained within the previous month).\n4. Presence of a mechanical ventricular assist device.\n5. Planned implantation of a ventricular assist device or cardiac transplantation.\n6. Non-cardiac comorbidities with a limited life expectancy (less than or equal to the study duration).\n7. Non-cardiac conditions (neurological or orthopedic) preventing performance of the 6-minute walk test (6MWT).\n8. Body mass index (BMI) ≥ 35 kg\u002Fm².\n9. Amyloid, hypertrophic obstructive, or constrictive cardiomyopathy.\n10. Presence of an accessory atrioventricular conduction pathway (e.g., Wolff-Parkinson-White syndrome).\n11. History of symptomatic or sustained ventricular tachyarrhythmia (≥ 30 seconds).\n12. Intermittent complete atrioventricular block or Mobitz type II second-degree AV block without pacemaker or ICD.\n13. Severe aortic valvular disease (grade III\u002FIII) with indication for invasive treatment.\n14. Complex congenital heart disease.\n15. Known hypersensitivity to digoxin (including prior adverse reactions).\n16. Current treatment with digoxin.\n17. Participation in another clinical trial (excluding observational registries).\n18. Pregnant or breastfeeding women, or women with the potential to become pregnant during the study period.\n\n    \\-","120 Years",{"count":108,"type":21},120,[110],"PHASE4","The DIG-DICA trial is a randomized, controlled, open-label, single-center study designed to evaluate whether adding low-dose digoxin to optimal medical therapy after an episode of acute decompensated heart failure improves patients' clinical status and quality of life. The study enrolls adults with heart failure with reduced ejection fraction (HFrEF) who have recently stabilized after hospitalization or urgent care for decompensation. The primary aim is to determine whether digoxin increases the proportion of patients who are \"Alive and Well\" at 180 days-defined by achieving a Kansas City Cardiomyopathy Questionnaire (KCCQ-12) score ≥75. The trial also explores effects on symptoms, functional capacity, biomarkers, renal function, and major cardiovascular events. The goal is to clarify whether modern low-dose digoxin provides meaningful clinical benefit in contemporary heart failure management.",[26],[114,115,116],"Systolic Heart Failure","Digoxin","Quality of Life","2026-05-29",{"date":119,"type":32},"2026-06-02",{"date":121,"type":32},"2025-12-16",{"date":123,"type":21},"2028-12-16",{"name":125,"class":39},"Hospital General de Agudos \"Dr. Cosme Argerich\"",{"id":127,"slug":128,"hasResults":12,"nctId":129,"briefTitle":130,"officialTitle":131,"acronym":132,"eligibilityCriteria":133,"healthyVolunteers":12,"sex":17,"minAge":134,"maxAge":4,"enrollmentInfo":135,"targetDuration":137,"studyType":23,"phases":4,"briefSummary":138,"conditions":139,"keywords":140,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":144,"lastUpdatePostDateStruct":145,"startDateStruct":147,"completionDateStruct":149,"leadSponsor":151,"locationsCount":69},"100637994","acute-heart-failure-registry-100637994","NCT07601022","Acute Heart Failure Registry","Clinical Utility of Quantitative Electrocardiography in Patients With Acute Heart Failure: A Prospective Observational Study","B-AHF","Inclusion Criteria:\n\n* Adults aged 19 years or older who were admitted to the Department of Cardiology for acute heart failure\n* NT-proBNP ≥300 pg\u002FmL\n* Patients who underwent electrocardiography at least once\n\nExclusion Criteria:\n\n* History of congenital heart disease\n* Patients with a dominant electronic pacemaker rhythm\n* Patients with a heart rate \\>140 beats per minute or electrocardiograms with excessive noise","19 Years",{"count":136,"type":21},400,"1 Year","To evaluate the clinical utility of quantitative electrocardiography (Quantitative ECG, QCG) by analyzing its associations with clinical characteristics and laboratory findings in patients hospitalized with acute heart failure.",[26],[141,142,143],"acute heart failure","heart failure","electrocardiography","2026-05-28",{"date":146,"type":32},"2026-06-01",{"date":148,"type":32},"2026-05-08",{"date":150,"type":21},"2030-12-31",{"name":152,"class":39},"Jin Joo Park",{"id":154,"slug":155,"hasResults":12,"nctId":156,"briefTitle":157,"officialTitle":157,"acronym":4,"eligibilityCriteria":158,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":159,"targetDuration":4,"studyType":50,"phases":160,"briefSummary":161,"conditions":162,"keywords":167,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":171,"lastUpdatePostDateStruct":172,"startDateStruct":173,"completionDateStruct":175,"leadSponsor":177,"locationsCount":69},"100640061","phase-4-pre-discharge-influenza-vaccination-in-patients-hospitalized-for-acute-cardiac-conditions-100640061","NCT07617376","Pre-discharge Influenza Vaccination in Patients Hospitalized for Acute Cardiac Conditions","Inclusion Criteria:\n\n* Acute cardiac hospitalization,\n* Planned discharge home within the next 48 hours following completion of in-hospital treatment,\n* No prior influenza vaccination for the current influenza season.\n\nExclusion Criteria:\n\n* History of a severe adverse reaction to influenza vaccination,\n* Allergy to any component of the vaccine to be administered,\n* Discharge to another hospital for continuation of treatment or discharge to a long-term care facility,\n* Antibiotic therapy to be continued after discharge.",{"count":136,"type":21},[110],"Patients hospitalized for acute cardiac conditions-including acute myocardial infarction, acute heart failure, pulmonary embolism, arrhythmias, and hypertensive emergencies-represent a heterogeneous population at very high risk of recurrent cardiovascular events. Influenza infection may act as a trigger for adverse cardiovascular events. Given the persistently low influenza vaccination uptake despite evidence-based benefits observed in vulnerable populations, including patients with cardiac conditions, new strategies to improve vaccination coverage are being explored. Recently, increasing attention has been directed toward an approach already used in fields such as neonatology, where vaccinations are administered prior to hospital discharge.\n\nIn this investigator-initiated, single-center, randomized, open-label interventional study, we will evaluate whether influenza vaccination administered within 24 hours before hospital discharge in patients hospitalized for acute cardiac conditions is safe and effective in reducing subsequent infections, cardiovascular events, and mortality during the 6 months following hospitalization.",[163,27,26,164,165,166],"Myocardial Infarction","Pulmonary Embolism Acute","Hypertension Emergency","Arrhythmias",[168,169,170],"influenza vaccination","acute cardiac emergencies","pre-discharg vaccination","2026-05-20",{"date":146,"type":32},{"date":174,"type":32},"2025-11-12",{"date":176,"type":21},"2027-07-01",{"name":178,"class":39},"Wroclaw Medical University",{"id":180,"slug":181,"hasResults":12,"nctId":182,"briefTitle":183,"officialTitle":184,"acronym":185,"eligibilityCriteria":186,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":187,"targetDuration":4,"studyType":23,"phases":4,"briefSummary":189,"conditions":190,"keywords":192,"overallStatus":200,"whyStopped":4,"lastUpdateSubmitDate":201,"lastUpdatePostDateStruct":202,"startDateStruct":204,"completionDateStruct":206,"leadSponsor":208,"locationsCount":209},"100637510","urinary-chloride-and-sodium-changes-and-residual-congestion-in-acute-heart-failure-100637510","NCT07597512","Urinary Chloride and Sodium Changes and Residual Congestion in Acute Heart Failure","Association of Urinary Chloride and Sodium Dynamics With Multiparametrically Assessed Residual Congestion in Acute Heart Failure (CLORINA-IC)","CLORINA-IC","Inclusion Criteria:\n\n* Provision of written informed consent prior to any study-related procedures;\n* Age ≥ 18 years;\n* Episode of AHF requiring hospital admission and treatment with intravenous furosemide;\n* New York Heart Association (NYHA) functional class II-IV;\n* NT-proBNP \\>1000 pg\u002FmL or BNP \\>250 pg\u002FmL, measured within a period not exceeding 24 hours prior to inclusion;\n* Transthoracic echocardiogram performed within the previous 24 months. All LVEF categories will be included: reduced LVEF (\\\u003C40%), mildly reduced LVEF (41-49%), and preserved LVEF (≥50%). In patients with preserved LVEF (HFpEF), congruent structural and\u002For functional echocardiographic abnormalities are required (left ventricular hypertrophy defined as septal or posterior wall thickness ≥11 mm, E\u002Fe' \\>9, or left atrial volume \\>32 mL\u002Fm²);\n* Signs of fluid overload, with at least two of the following: jugular venous distension (at least up to the sternocleidomastoid level, \\~10 cm), lower limb edema, ascites, or pleural effusion confirmed by chest radiography or lung ultrasound\n* Treatment with oral furosemide at a dose of at least 40 mg\u002Fday within the previous month.\n\nExclusion Criteria:\n\n* Symptomatic hyponatremia or plasma sodium level ≤125 mmol\u002FL;\n* Hemoglobin \\\u003C9 g\u002FdL;\n* Hypokalemia: serum potassium \\\u003C3 mEq\u002FL;\n* Chronic kidney disease with estimated glomerular filtration rate (eGFR) \\\u003C15 mL\u002Fmin\u002F1.73 m²;\n* Hemodynamic instability at admission, defined as symptomatic hypotension;\n* Acute coronary syndrome, cardiogenic shock, or admission to the intensive care unit (ICU);\n* Severe infection (e.g., pneumonia, sepsis, leukocyte count ≥12,000\u002FμL, C-reactive protein \\>50 mg\u002FL, or positive COVID-19 test);\n* Requirement for inotropic agents;\n* Life expectancy \\\u003C3 months or, in the investigator's judgment, inability to comply with study procedures.",{"count":188,"type":21},223,"The goal of this observational study is to learn how changes in urinary sodium and chloride levels relate to fluid overload and short-term outcomes in patients hospitalized with acute heart failure (AHF). The main questions it aims to answer are:\n\n* Do changes over time in urinary sodium and chloride reflect how well excess fluid is being removed during hospitalization?\n* Are these changes associated with residual congestion at discharge and with the risk of worsening heart failure or death after discharge?\n\nParticipants hospitalized for AHF and treated with intravenous diuretics as part of their usual care will have clinical assessments, blood and urine tests, and echocardiographic evaluations collected at several time points during their hospital stay. Researchers will also record clinical outcomes, including worsening heart failure or death, at 30 days and 3 months after discharge.",[26,84,191],"Congestion",[193,194,87,191,195,196,197,198,199],"Acute Heart Failure","Heart failure","Urinary chloride","Urinary sodium","Diuretics","point of care ultrasound","POCUS","NOT_YET_RECRUITING","2026-05-19",{"date":203,"type":32},"2026-05-22",{"date":205,"type":21},"2026-05",{"date":207,"type":21},"2028-12-31",{"name":97,"class":39},4,{"id":211,"slug":212,"hasResults":12,"nctId":213,"briefTitle":214,"officialTitle":215,"acronym":216,"eligibilityCriteria":217,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":218,"targetDuration":4,"studyType":50,"phases":220,"briefSummary":221,"conditions":222,"keywords":223,"overallStatus":200,"whyStopped":4,"lastUpdateSubmitDate":225,"lastUpdatePostDateStruct":226,"startDateStruct":228,"completionDateStruct":230,"leadSponsor":232,"locationsCount":4},"100637534","phase-4-tactic-hf-sequential-diuretic-strategies-in-ambulatory-worsening-heart-failure-100637534","NCT07593612","TACTIC-HF: Sequential Diuretic Strategies in Ambulatory Worsening Heart Failure","TACTIC-HF: Thiazide or Acetazolamide Combination Versus Intravenous Furosemide in Ambulatory Worsening Heart Failure - a Randomized Crossover Trial","TACTIC-HF","Inclusion Criteria:\n\n* Age ≥18 years Chronic heart failure diagnosis according to current guideline definitions Ambulatory worsening heart failure requiring intravenous diuretic therapy in a specialized outpatient setting Evidence of clinical or objective congestion Chronic outpatient loop diuretic therapy Ability to comply with study procedures Written informed consent\n\nExclusion Criteria:\n\n* Hemodynamic instability or cardiogenic shock Requirement for immediate hospitalization Acute coronary syndrome, active infection, pulmonary embolism, or uncontrolled arrhythmia Severe electrolyte abnormalities Advanced renal failure requiring dialysis Pregnancy or breastfeeding Contraindication or allergy to study medications Current treatment with acetazolamide or thiazide diuretics Any condition that, in the opinion of the investigators, would make study participation unsafe or interfere with study procedures",{"count":219,"type":21},60,[110],"TACTIC-HF is a prospective randomized crossover trial designed to compare three ambulatory diuretic strategies in patients with worsening heart failure treated in a specialized heart failure day-hospital program.\n\nParticipants will receive sequential treatment with:\n\n1. intravenous furosemide alone,\n2. intravenous furosemide combined with oral acetazolamide, and\n3. intravenous furosemide combined with oral hydrochlorothiazide.\n\nThe primary objective is to compare short-term natriuretic response between strategies. Secondary objectives include assessment of urine output, congestion parameters, and renal\u002Felectrolyte safety.\n\nEach participant will undergo repeated outpatient treatment sessions separated by washout periods, with standardized clinical and laboratory monitoring performed during each visit.\n\nThe study aims to evaluate pragmatic and clinically applicable ambulatory decongestion strategies using approved therapies commonly available in real-world practice.",[26],[224],"worsening heart failure","2026-05-11",{"date":227,"type":32},"2026-05-18",{"date":229,"type":21},"2026-06-15",{"date":231,"type":21},"2027-01-15",{"name":233,"class":39},"Lucrecia Maria Burgos",{"id":235,"slug":236,"hasResults":12,"nctId":237,"briefTitle":238,"officialTitle":239,"acronym":240,"eligibilityCriteria":241,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":242,"targetDuration":4,"studyType":50,"phases":244,"briefSummary":245,"conditions":246,"keywords":247,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":253,"lastUpdatePostDateStruct":254,"startDateStruct":256,"completionDateStruct":258,"leadSponsor":260,"locationsCount":69},"100623773","restrictive-versus-liberal-fluid-intake-in-acute-decompensated-heart-failure-100623773","NCT07400991","Restrictive Versus Liberal Fluid Intake in Acute Decompensated Heart Failure","Restrictive Versus Liberal Fluid Intake in Acute Decompensated Heart Failure: a Randomized Trial","RELIEF-AHF","Inclusion Criteria:\n\n1. Age \\>18 years\n2. Hospitalized for ADHF as the primary diagnosis, meeting both of the following:\n\n   1. ≥1 documented symptom of new or worsening heart failure (dyspnea, fatigue, decreased exercise tolerance, or symptom of end-organ hypoperfusion).\n   2. Objective evidence of ADHF, defined as either:\n\n   i. ≥2 physical signs (edema, ascites, pulmonary rales\u002Fcrackles, increased JVP, S3 gallop, rapid weight gain due to fluid retention), OR ii. ≥1 physical sign AND ≥1 laboratory finding indicative of ADHF (BNP \\>500 ng\u002FL or NT-proBNP \\>2000 ng\u002FL if sinus rhythm, or BNP \\>750 ng\u002FL or NT-proBNP \\>3000 ng\u002FL if atrial fibrillation, radiological\u002Fultrasound evidence of pulmonary congestion, echocardiographic sign \\[VCI \\>2.1 cm, LVOT VTI \\\u003C15 cm, E\u002Fe' \\>14, D-dominant pulmonary venous inflow pattern\\], or invasive evidence \\[CVP \\>12 mmHg, PCWP \\>18 mmHg, CI \\\u003C2.2 L\u002Fmin\u002Fm2\\]).\n3. Treatment with ≥40 mg IV furosemide (or equivalent)\n4. Enrolment within 24 hours of admission\n5. Ability to provide informed consent\n\nExclusion Criteria:\n\n1. Requirement at admission for ICU-level care, or IV inotropic\u002Fvasopressor therapy for ADHF.\n2. Na+ \\\u003C125 mmol\u002FL or Na+ \\>145 mmol\u002FL.\n3. End-stage chronic kidney disease on chronic dialysis or eGFR \\\u003C15 mL\u002Fmin\u002F1.73 m2\n4. Any condition which would make participation unsafe or substantially affect protocol adherence, as judged by investigator.",{"count":243,"type":21},420,[52],"The aim of this clinical trial is to learn whether a thirst-driven, liberal fluid-intake strategy is comparable to a fluid-restriction strategy in patients hospitalized for acute decompensated heart failure (ADHF). The study will also assess the safety of the intervention and its effects on thirst and quality of life.\n\nPatients hospitalized with ADHF will be asked to follow either a thirst-driven fluid-intake strategy or a fluid-restriction strategy during their hospital stay and for one month after discharge.",[26],[248,249,250,251,252],"Fluid Restriction","Thirst-driven fluid intake","Liberal fluid intake","Acute heart failure","Time to clinical stability","2026-05-04",{"date":255,"type":32},"2026-05-07",{"date":257,"type":32},"2026-05-01",{"date":259,"type":21},"2029-08",{"name":261,"class":39},"Gødstrup Hospital",{"id":263,"slug":264,"hasResults":12,"nctId":265,"briefTitle":266,"officialTitle":267,"acronym":4,"eligibilityCriteria":268,"healthyVolunteers":269,"sex":17,"minAge":4,"maxAge":4,"enrollmentInfo":270,"targetDuration":4,"studyType":50,"phases":272,"briefSummary":273,"conditions":274,"keywords":277,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":287,"lastUpdatePostDateStruct":288,"startDateStruct":290,"completionDateStruct":292,"leadSponsor":294,"locationsCount":69},"100634598","training-medical-residents-in-the-use-of-the-venous-excess-ultrasound-vexus-score-for-bedside-volume-assessment-100634598","NCT07541768","Training Medical Residents in the Use of the Venous Excess UltraSound (VExUS) Score for Bedside Volume Assessment.","Training Medical Residents in the Use of the Venous Excess UltraSound (VExUS) Score for Bedside Volume Assessment: a Randomized Controlled Trial","Inclusion Criteria:\n\n* Medical residents in general internal medicine\n* Basic ultrasound skills (POCUS component 1 or ≥200 scans)\n* Working at study site during study period\n\nExclusion Criteria:\n\n* SGUM certification in abdominal ultrasound\n* Advanced duplex ultrasound experience\n* Prior vascular\u002Fduplex training",true,{"count":271,"type":21},23,[52],"This randomized controlled trial evaluates the effectiveness of two training approaches (in-person versus remote) for teaching medical residents to apply the Venous Excess Ultrasound (VExUS) score for bedside volume assessment in patients with acute heart failure. Resident performance will be compared to that of expert physicians certified in abdominal and duplex sonography.",[26,275,191,276],"Fluid Over-load","Congestion, Venous",[278,279,280,199,281,282,283,284,285,286],"Vexus","Venous Excess Ultrasound","Point-of-Care Ultrasound","Ultrasound Training","Medical Education","Volume Assessment","Venous Congestion","Duplex Ultrasound","Bedside Ultrasound","2026-04-16",{"date":289,"type":32},"2026-04-21",{"date":291,"type":32},"2026-03-20",{"date":293,"type":21},"2026-12-31",{"name":295,"class":39},"Insel Gruppe AG, University Hospital Bern",{"id":297,"slug":298,"hasResults":12,"nctId":299,"briefTitle":300,"officialTitle":301,"acronym":302,"eligibilityCriteria":303,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":304,"targetDuration":4,"studyType":50,"phases":306,"briefSummary":307,"conditions":308,"keywords":312,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":315,"lastUpdatePostDateStruct":316,"startDateStruct":318,"completionDateStruct":320,"leadSponsor":322,"locationsCount":69},"100633474","phase-4-prolonged-nasogastric-administration-of-ketones-in-decompensated-heart-failure-100633474","NCT07527156","Prolonged Nasogastric Administration of Ketones in Decompensated Heart Failure","Feasibility and Safety of Prolonged Nasogastric Administration of Ketones in Decompensated Heart Failure","KADHEF-2","Inclusion Criteria:\n\n* LVEF \\\u003C35%\n* Acute heart failure with low cardiac output syndrome or cardiogenic shock\n\nExclusion Criteria:\n\n* Severe liver failure\n* Severe acidosis\n* Inability to insert nasogastric tube\n* Gastric paralysis \u002F ileus\n* Repeated vomiting\n* Severe hypokalemia",{"count":305,"type":21},12,[110],"This study will evaluate the feasibility and safety of achieving therapeutic concentrations of beta-hydroxybutyrate using continuous infusion of D-beta-hydroxybutyrate monoester administered via a nasogastric tube in patients with acutely decompensated heart failure with reduced left ventricular ejection fraction.",[26,309,84,310,311],"Cardiogenic Shock","Ketones","Ketone Body Metabolism",[141,313,314],"ketones","ketone body","2026-04-07",{"date":317,"type":32},"2026-04-14",{"date":319,"type":32},"2026-04-04",{"date":321,"type":21},"2027-03-31",{"name":323,"class":324},"Institute for Clinical and Experimental Medicine","OTHER_GOV",{"id":326,"slug":327,"hasResults":12,"nctId":328,"briefTitle":329,"officialTitle":329,"acronym":330,"eligibilityCriteria":331,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":332,"targetDuration":4,"studyType":50,"phases":334,"briefSummary":335,"conditions":336,"keywords":339,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":346,"lastUpdatePostDateStruct":347,"startDateStruct":349,"completionDateStruct":351,"leadSponsor":353,"locationsCount":69},"100613165","phase-4-urine-sodium-driven-diuretic-adjustment-strategy-in-acute-decompensated-heart-failure-100613165","NCT07263035","Urine Sodium-Driven Diuretic Adjustment Strategy in Acute Decompensated Heart Failure","US-DASH","Inclusion Criteria:\n\n* The study will target adults 18 years of age or older admitted to Lakeland Regional Medical Center who:\n\n  * Have a primary diagnosis of acute decompensated heart failure, and\n  * Have at least one of the following signs of hypervolemia:\n\n    * Bilateral lower extremity pitting edema\n    * Jugular venous distension\n    * Hepatojugular reflex\n    * Crackles on pulmonary exam, or\n    * Chest x-ray demonstrating pulmonary edema or pleural effusions\n\nExclusion Criteria:\n\n* Exclusion criteria include:\n\n  * Admission to the intensive care unit\n  * Presence of ST-elevated myocardial infarction\n  * Presence of type 1 non-ST elevated myocardial infarction\n  * Dyspnea primarily due to non-cardiac cause as judged by the emergency medicine physician or admitting physician\n  * Use of supplemental oxygen totaling at least 3 L per minute or greater at baseline\n  * Anuria\n  * End-stage renal disease per KDIGO criteria\n  * Dialysis use",{"count":333,"type":21},600,[110],"The goal of this clinical trial is to learn if increasing the dose of diuretics to achieve a higher urine sodium target produces better clinical results when treating patients hospitalized with acute heart failure when compared to lower urine sodium target and standard of care.\n\nThe main questions it aims to answer are:\n\n1. Does targeting a higher urine sodium goal achieve greater natriuresis and diuresis?\n2. Does targeting a higher urine sodium goal reduce frequency of hospital readmissions?\n3. Does targeting a higher urine sodium goal reduce hospital length of stay?\n\nResearchers will compare natriuresis-guided arms with standard of care to see if targeting higher natriuresis goals improves significantly over current practice.\n\nParticipants will submit urine samples at routine intervals after being given diuretics to evaluate urine sodium concentration. If urine sodium is low then diuretic dose will be increased.",[84,337,338,26],"Heart Failure - NYHA II - IV","Heart Failure Acute",[340,197,341,142,342,343,344,345],"Urine sodium","Lasix","Acute CHF","acute HFrEF","Acute HFpEF","Natriuresis","2026-04-06",{"date":348,"type":32},"2026-04-09",{"date":350,"type":32},"2026-04-01",{"date":352,"type":21},"2027-09-01",{"name":354,"class":39},"Lakeland Regional Health Systems, Inc.",{"id":356,"slug":357,"hasResults":12,"nctId":358,"briefTitle":359,"officialTitle":359,"acronym":360,"eligibilityCriteria":361,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":362,"targetDuration":4,"studyType":23,"phases":4,"briefSummary":363,"conditions":364,"keywords":4,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":365,"lastUpdatePostDateStruct":366,"startDateStruct":367,"completionDateStruct":369,"leadSponsor":371,"locationsCount":209},"100632578","multimodal-phenotyping-in-patients-referred-with-acute-cardiac-failure-100632578","NCT07515508","Multimodal Phenotyping In Patients Referred With Acute Cardiac faiLurE","MIRACLE","Inclusion Criteria:\n\n* Patients hospitalized with acute heart failure SCAI stage B - E.\n\nExclusion Criteria:\n\n* Not capable of providing informed consent due to reasons not attributable to cardiogenic shock\n* Cardiogenic shock following cardiothoracic surgery",{"count":333,"type":21},"The goal of this observational study is to learn whether information collected during routine hospital care, together with blood and urine samples, can help doctors better identify different types of cardiogenic shock and better predict outcomes in adults hospitalized with acute heart failure and cardiogenic shock. The main question is whether clinical findings, imaging results, and biomarkers, including sex-specific factors, are associated with the risk of death within 30 days. Participants will not receive an experimental treatment. Researchers will collect data from routine care, collect additional blood and urine samples for biobanking, and follow participants after hospital discharge",[309,26],"2026-03-31",{"date":315,"type":32},{"date":368,"type":32},"2024-08-07",{"date":370,"type":21},"2028-07-31",{"name":372,"class":39},"University Heart Center Freiburg - Bad Krozingen",{"id":374,"slug":375,"hasResults":12,"nctId":376,"briefTitle":377,"officialTitle":378,"acronym":379,"eligibilityCriteria":380,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":381,"targetDuration":4,"studyType":50,"phases":383,"briefSummary":384,"conditions":385,"keywords":388,"overallStatus":200,"whyStopped":4,"lastUpdateSubmitDate":390,"lastUpdatePostDateStruct":391,"startDateStruct":393,"completionDateStruct":395,"leadSponsor":397,"locationsCount":399},"100631360","pulmonary-embolism-in-patients-with-acute-heart-failure-pehf-study-100631360","NCT07499661","Pulmonary Embolism in Patients With Acute Heart Failure (PEHF Study)","Pulmonary Embolism in Patients With Acute Heart Failure: A Pragmatic Cluster-Randomized Trial (PEHF Study)","PEHF","Inclusion Criteria:\n\n* Adult patient (≥18 years)\n* Admission to the emergency department or cardiology unit of a participating center\n* Recent onset or worsening dyspnea and\u002For orthopnea\n* Diagnosis of acute heart failure defined by recent dyspnea associated with at least one of the following:\n\n  * Bilateral pulmonary crackles on auscultation and\u002For peripheral edema\n  * Signs of pulmonary congestion on chest X-ray or lung\u002Fcardiac ultrasound\n  * Elevated natriuretic peptide levels (BNP or NT-proBNP)\n  * Documented history of heart failure (known chronic heart failure or prior hospitalization for acute heart failure)\n* Patient affiliated with or beneficiary of a social security system\n* Patient able and willing to provide free, informed, and written consent\n\nExclusion Criteria:\n\n* Shock state suggesting cardiogenic shock and\u002For severe pulmonary embolism\n* Severe respiratory distress at inclusion preventing appropriate positioning or performance of imaging examinations\n* Evidence of acute coronary syndrome on electrocardiogram at admission\n* Severe renal impairment (creatinine clearance \\\u003C30 mL\u002Fmin)\n* Known hypersensitivity or allergy to iodinated contrast agents\n* Ongoing therapeutic anticoagulation for more than 48 hours prior to admission\n* Hospitalization for more than 48 hours prior to inclusion\n* Inability to ensure 90-day follow-up (e.g., end-of-life situation, no fixed address, patient not reachable)\n* Inadequate understanding of the French language preventing proper study information and consent\n* Pregnant, breastfeeding, or postpartum women\n* Individuals under legal protection or other vulnerable populations, including minors and protected adults, in accordance with applicable public health regulations (Articles L.1121-5 to L.1121-8 and L.1122-1-2 of the French Public Health Code)",{"count":382,"type":21},740,[52],"This study focuses on two serious and common medical conditions: heart failure and pulmonary embolism (a blood clot in the lungs). Heart failure happens when the heart cannot pump blood effectively, and it is one of the main reasons older adults are admitted to the hospital. Pulmonary embolism can be life-threatening and may worsen heart failure or even trigger it.\n\nDoctors believe that pulmonary embolism may often go undetected in patients who come to the hospital with symptoms of acute heart failure, such as sudden shortness of breath. This is because both conditions can cause similar symptoms, making it difficult to tell them apart. As a result, doctors may sometimes assume the symptoms are only due to heart failure and not investigate further for a possible blood clot.\n\nHowever, missing a pulmonary embolism can have serious consequences. Studies suggest that some patients with heart failure who die may actually have had an undiagnosed pulmonary embolism. Current medical guidelines recommend checking for pulmonary embolism when the cause of breathing problems is unclear, but in real-life practice, this is not always done.\n\nThe goal of this study is to find out whether pulmonary embolism is underdiagnosed in patients with suspected acute heart failure and whether systematically testing for it could improve patient outcomes.\n\nTo do this, the study will compare two approaches in several hospitals. In half of the hospitals, doctors will follow their usual practice and decide case by case whether to test for pulmonary embolism. In the other half, doctors will systematically test all eligible patients for pulmonary embolism using recommended diagnostic methods.\n\nAdult patients admitted with recent or worsening breathing difficulties and signs of acute heart failure may be included in the study, provided they give their consent. Researchers will collect information about their symptoms, tests, diagnosis, and treatments.\n\nPatients will be monitored during their hospital stay and for three months afterward. The study will track important outcomes such as survival, new blood clots, bleeding events, repeated hospital visits for breathing problems, and overall time spent in the hospital.\n\nThe researchers expect to include about 740 patients in total. They estimate that pulmonary embolism may be found in about 1% of patients with usual care, but up to 5% when doctors systematically look for it.\n\nThis study aims to better understand how often pulmonary embolism occurs in patients with acute heart failure and whether more systematic testing could lead to earlier diagnosis and better care. The results could help improve medical practice and reduce complications or deaths related to missed diagnoses.",[26,386,387],"Pulmonary Embolism (Diagnosis)","Venous Thromboembolism",[389],"Cluster-randomized trial","2026-03-30",{"date":392,"type":32},"2026-04-03",{"date":394,"type":21},"2026-06",{"date":396,"type":21},"2028-09",{"name":398,"class":324},"University Hospital, Angers",10,{"id":401,"slug":402,"hasResults":12,"nctId":403,"briefTitle":404,"officialTitle":405,"acronym":406,"eligibilityCriteria":407,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":408,"targetDuration":4,"studyType":50,"phases":410,"briefSummary":411,"conditions":412,"keywords":415,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":419,"lastUpdatePostDateStruct":420,"startDateStruct":422,"completionDateStruct":424,"leadSponsor":426,"locationsCount":7},"100630156","reds-guided-decongestion-strategy-in-patients-hospitalized-for-heart-failure-100630156","NCT07484009","ReDS-guided Decongestion Strategy in Patients Hospitalized for Heart Failure","ReDS-guided Decongestion Strategy in Patients Hospitalized for Heart Failure: the ReDS-SAFE HF II Trial","ReDS-SAFE HF 2","Inclusion Criteria:\n\n1. Hospitalized due to heart failure as the main reason, including the presence of symptoms and signs of congestion, regardless of the left ventricular ejection fraction (LVEF).\n2. NT-proBNP greater than 1000 pg\u002FL or BNP greater than 300 pg\u002FL upon admission.\n\nExclusion Criteria:\n\n1. Height less than 150 cm or greater than 190 cm or body mass index (BMI) less than 22 or greater than 39, conditions where the use of ReDS is not approved.\n2. Patients requiring inotropes (levosimendan is allowed) or vasopressors upon admission, with mechanical support, or heart transplant recipients.\n3. Any malformation or variant affecting the right lung anatomy (e.g., a pacemaker).\n4. Patients with any heart disease requiring a planned surgical intervention (CABG, valve disease, or other) or percutaneous (TAVR, STE-ACS, mitral or tricuspid valve repair, CRT) during the clinical trial.\n5. Chronic kidney disease with a GFR \\\u003C20 or on hemodialysis.\n6. Life expectancy less than 12 months due to non-cardiological origin.\n7. Participation in another clinical trial with intervention.",{"count":409,"type":21},1014,[52],"This clinical trial aims to determine whether a ReDS-guided treatment strategy is superior to the current standard of care for adults hospitalized with heart failure. Additionally, the study will evaluate the safety and cost-effectiveness of this approach.\n\nThe study seeks to answer the following key questions:\n\n1. Does the ReDS-guided strategy reduce the risk of cardiovascular events during the first month following hospital discharge?\n2. What is the safety profile of this treatment strategy?\n\nResearchers will compare the ReDS-based strategy against the current standard of care. All participants will:\n\n* Undergo daily assessments using the ReDS device throughout their hospitalization.\n* Attend two follow-up visits post-discharge, scheduled at 2 weeks and 30 days.",[26,413,414],"Heart Failure (for Example, Fluid Overload)","Heart Failure Hospitalization",[194,191,416,417,418],"ReDS","Fluid Overload","Randomized Clinical Trial","2026-03-16",{"date":421,"type":32},"2026-03-19",{"date":423,"type":32},"2026-01-29",{"date":425,"type":21},"2027-08-31",{"name":97,"class":39},{"id":428,"slug":429,"hasResults":12,"nctId":430,"briefTitle":431,"officialTitle":432,"acronym":433,"eligibilityCriteria":434,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":435,"targetDuration":4,"studyType":50,"phases":437,"briefSummary":440,"conditions":441,"keywords":447,"overallStatus":200,"whyStopped":4,"lastUpdateSubmitDate":419,"lastUpdatePostDateStruct":451,"startDateStruct":453,"completionDateStruct":455,"leadSponsor":457,"locationsCount":69},"100629059","phase-2-pocus-intervention-for-tailoring-diuretic-strategy-in-acute-decompensated-heart-failure-100629059","NCT07469722","POcus INTERvention for Tailoring Diuretic Strategy in Acute Decompensated Heart Failure","Point-of-care Ultrasound Intervention for Tailoring Diuretic Strategy in Acute Decompensated Heart Failure","POINTER-HF","Inclusion Criteria:\n\n* Men or women aged 18 years or older.\n* Diagnosis of acute decompensated heart failure (ADHF) with left ventricular ejection fraction \\\u003C50%, presenting with symptoms (dyspnea, orthopnea, fatigue) and\u002For signs (pulmonary crackles, peripheral edema, jugular venous distension, hepatomegaly, hepatojugular reflux) of decompensated heart failure.\n* Brain natriuretic peptide (BNP) ≥ 300 pg\u002FmL.\n* Signs of systemic and\u002For pulmonary congestion on POCUS, defined as DUCS ≥ 3 points.\n* Time from hospital admission ≤ 48 hours.\n* Signed informed consent.\n\nExclusion Criteria:\n\n* Patients under evaluation for heart transplantation or with prior heart transplantation.\n* Acute coronary syndrome as the primary cause of hospitalization.\n* Evidence of uncontrolled infection.\n* Cardiac surgery or percutaneous coronary or structural cardiac intervention within the previous 30 days.\n* Signs of hypoperfusion, defined as any of the following: mean arterial pressure \\\u003C 60 mmHg, capillary refill time \\> 4 seconds, arterial lactate \\> 2 mmol\u002FL or venous lactate \\> 2.5 mmol\u002FL.\n* Acute pulmonary embolism (segmental or more proximal) as the primary cause of hospitalization.\n* Acute stroke.\n* Chronic kidney disease stage 5 (estimated glomerular filtration rate \\\u003C 15 ml\u002Fmin\u002Fm²) or requirement for renal replacement therapy.\n* Liver cirrhosis with portal hypertension.\n* Known pulmonary disease with extensive parenchymal involvement, including interstitial lung disease, pulmonary metastases, prior pneumonectomy, lobectomy, or pleurodesis.\n* Severe hypokalemia (serum potassium \\\u003C 2.5 mmol\u002FL).\n* Pregnancy or breastfeeding.\n* Refusal to participate in the clinical trial.",{"count":436,"type":21},128,[438,439],"PHASE2","PHASE3","Acute decompensated heart failure (ADHF) is a frequent cause of hospitalization and is associated with high morbidity and mortality. Congestion is the primary pathophysiological mechanism leading to clinical deterioration and hospitalization in ADHF. Diuretics remain the cornerstone of treatment for most ADHF phenotypes; however, evidence regarding optimal strategies to guide diuretic therapy during the decongestion process is limited. Recently, point-of-care ultrasound (POCUS) has emerged as a promising tool to support clinical assessment in ADHF, improving diagnostic accuracy, prognostication, and pre-discharge evaluation. Nevertheless, the role of POCUS in guiding therapeutic management in ADHF remains uncertain. To specifically assess congestion in patients with ADHF, a pragmatic POCUS-based score, the Dynamic Ultrasound Congestion Score (DUCS), was developed. DUCS integrates lung ultrasound and Venous Excess Ultrasound (VExUS) to dynamically evaluate congestion severity, treatment response, and therapeutic goals during ADHF management. Observational data suggest that DUCS is associated with in-hospital outcomes and short-term prognosis, and correlates with markers of decongestion such as urinary output and weight loss. This study is a randomized, single-center, single-blind clinical trial designed to evaluate whether a DUCS-guided POCUS strategy improves clinical and decongestion outcomes compared with standard of care. Eligible patients hospitalized due to ADHF will be randomized within 48 hours of admission to one of two groups: (1) diuretic treatment guided by institutional standard-of-care combined with information from the EVEREST congestion score assessment and guideline-based treatment recommendations; or (2) diuretic treatment guided by serial DUCS-based POCUS assessments used to inform diuretic adjustment recommendations. Participants in both groups will undergo evaluations at baseline (day 1), day 2, day 3 and day 5, including clinical data collection, physical examination using the EVEREST congestion score, and standardized DUCS-based POCUS assessments. Outcomes to be assessed include in-hospital mortality, length of hospital stay, decongestion parameters, and changes in biomarkers.",[26,442,443,444,445,446],"Congestive Heart Failure Acute","Diuretic Effect","Lung Ultrasonography Score","Ultrasonography, Doppler","Point-of-care Ultrasound (POCUS)",[193,448,280,449,279,450],"Congestive Heart Failure","Lung Ultrasound","Diuretic",{"date":452,"type":32},"2026-03-18",{"date":454,"type":21},"2026-03-23",{"date":456,"type":21},"2028-07-01",{"name":458,"class":39},"Hospital de Clinicas de Porto Alegre",{"id":460,"slug":461,"hasResults":12,"nctId":462,"briefTitle":463,"officialTitle":464,"acronym":465,"eligibilityCriteria":466,"healthyVolunteers":12,"sex":17,"minAge":467,"maxAge":4,"enrollmentInfo":468,"targetDuration":4,"studyType":50,"phases":470,"briefSummary":471,"conditions":472,"keywords":473,"overallStatus":200,"whyStopped":4,"lastUpdateSubmitDate":478,"lastUpdatePostDateStruct":479,"startDateStruct":481,"completionDateStruct":483,"leadSponsor":485,"locationsCount":4},"100623142","early-gliflozin-for-elderly-patients-with-acute-decompensated-heart-failure-in-the-emergency-department-100623142","NCT07392788","Early Gliflozin for Elderly Patients With Acute Decompensated Heart Failure in the Emergency Department","Early Gliflozin Treatment in Elderly Patient Hospitalized for Decompensated Chronic Heart Failure Admitted in the Emergency Room - a Feasibility Study","GlifloFastER","Inclusion Criteria:\n\n1. Age ≥ 75 years\n2. ED admission for ADCHF with:\n\n   * Worsening CHF symptoms (dyspnea, fatigue, weight gain, edema)\n   * Objective signs of peripheral\u002Fpulmonary congestion\n   * Elevated natriuretic peptides:\n\n     * Sinus rhythm: BNP ≥ 400 pg\u002FmL or NT-proBNP ≥ 1,600 pg\u002FmL\n     * Atrial fibrillation: BNP ≥ 600 pg\u002FmL or NT-proBNP ≥ 2,400 pg\u002FmL\n   * Need for treatment intensification\n3. Expected hospitalization\n4. No prior gliflozin treatment\n5. Signed informed consent\n\nExclusion Criteria:\n\n* Type 1 diabetes\n* Chronic kidney disease (eGFR \\\u003C 25ml\u002Fmin\u002F1.73m²)\n* Cardiogenic shock\n* Acute coronary syndrome (current or within 30 days)\n* Severe valvular disease requiring surgery\n* Recent\u002Fplanned coronary intervention\n* Known intolerance to study medication\n* Legal protection measure or inability to consent\n* Hospitalization in cardiology department\n* Discharge home or to nursing home","75 Years",{"count":469,"type":21},144,[52],"Background: SGLT2 inhibitors reduce CHF morbidity\u002Fmortality but are underutilized in elderly patients with acute decompensated CHF (ADCHF) admitted outside cardiology departments.\n\nObjective: Assess feasibility of early ED-initiated gliflozin therapy in elderly ADCHF patients.\n\nDesign: Multicenter, randomized, open-label pilot study; N=144 patients (72 per arm) across 6 EDs over 30 months.\n\nPopulation: Age ≥75 years, ED admission for ADCHF (symptomatic worsening, congestion, elevated natriuretic peptides), gliflozin-naïve, requiring hospitalization.\n\nKey Exclusions: Type 1 diabetes, eGFR \\\u003C25 mL\u002Fmin\u002F1.73m², cardiogenic shock, recent ACS, cardiology ward admission.\n\nIntervention:\n\nTreatment: Dapagliflozin 10mg daily within 24h + cardiac nurse telephone follow-up at 1 month Control: Standard care only Primary Outcome: Feasibility (organizational implementation, acceptability, protocol adherence, timeline compliance).\n\nFollow-up: 7-day visit (clinical assessment, NT-proBNP, echocardiography) and 3-month cardiology consultation (mortality, rehospitalization, QoL, biomarkers, safety parameters).",[26],[141,59,474,475,476,477],"elderly","SGLT2 Inhibitors","Feasibility study","Acute Decompensated Chronic Heart Failure","2026-02-05",{"date":480,"type":32},"2026-02-06",{"date":482,"type":21},"2026-04",{"date":484,"type":21},"2028-02",{"name":486,"class":39},"Centre Hospitalier Universitaire de Besancon",{"id":488,"slug":489,"hasResults":12,"nctId":490,"briefTitle":491,"officialTitle":492,"acronym":493,"eligibilityCriteria":494,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":495,"targetDuration":4,"studyType":50,"phases":496,"briefSummary":497,"conditions":498,"keywords":504,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":508,"lastUpdatePostDateStruct":509,"startDateStruct":511,"completionDateStruct":513,"leadSponsor":515,"locationsCount":69},"100604453","temporary-mcs-with-the-ivac-2l-transaortic-device-in-high-risk-pci-100604453","NCT07149714","Temporary MCS With the iVAC 2L Transaortic Device in High-risk PCI","Temporary Mechanical Circulatory Support With the iVAC 2L Transaortic Device in High-risk Percutaneous Coronary Intervention","POTOK","Inclusion Criteria:\n\n* Multidisciplinary heart team consensus for high-risk PCI. HR-PCI was defined as any percutaneous intervention for coronary disease involving an unusually high risk of periprocedural circulatory collapse.\n* Signed Informed Consent to participate in the study\n\nExclusion Criteria:\n\n* Femoral artery diameter \\\u003C 6.0mm\n* Significant biventricular or right heart failure\n* Thrombus in the left ventricle\n* Presence of a mechanical aortic valve\n* Aortic valve stenosis\u002Fcalcification (equivalent to an orifice area of 0.6 cm2 or less) or moderate-to-severe aortic insufficiency (echocardiographic assessment graded as ≥+2)\n* Severe peripheral arterial disease precluding placement of the iVAC2L\n* Combined cardiorespiratory failure\n* Presence of an atrial or ventricular septal defect (including post infarct VSD)\n* Left ventricular rupture\n* Cardiac tamponade\n* Presence of any other subtype of shock\n* Known severe comorbidities independently affecting prognosis (chronic renal or liver failure, active malignancies etc.)\n* Recent major bleeding event (\\\u003C 3 months)\n* Recent stroke (\\\u003C 3 months)",{"count":49,"type":21},[52],"Patients with coronary artery disease and undergoing high-risk percutaneous coronary intervention (PCI) are at increased risk of hemodynamic instability and poor outcomes. Mechanical circulatory support (MCS) devices may offer hemodynamic stabilization during PCI, potentially improving short- and long-term outcomes. The study rationale is to investigate the safety and clinical efficacy of temporary MCS with the iVAC 2L transaortic device in high-risk percutaneous coronary intervention.\n\nThe transaortic system for short-term circulatory support with pulsatile blood flow iVAC 2L consists of an external membrane pump, a 17Fr diameter catheter for reversed blood flow (intake cannula) with a patented two-way rotary valve.\n\nThe pump has two chambers, one for blood and one for helium, separated by a flexible diaphragm. The blood chamber connects to the catheter and the air chamber connects to a standard IABP console. The bi-directional valve is located 72 mm from the aspiration tip of the catheter and determines the direction of blood flow. The catheter is advanced retrogradely through the common femoral artery so that the tip is located in the left ventricular (LV) cavity and the valve is in the ascending aorta. Synchronized with the cardiac cycle via ECG, the device draws blood from the LV into the pump chamber during systole and ejects blood from the pump into the ascending aorta during diastole.\n\nThe primary composite outcome is all-cause mortality, including acute myocardial infarction, stroke and TIA during hospitalization and at Day 360 of follow-up, expressed as a percentage of total patients.",[499,500,501,309,26,502,503],"Ischemic Cardiovascular Disease","Multivessel Coronary Artery Disease","Coronary Artery Disease","Chronic Heart Failure","Percutaneous Coronary Intervention",[505,506,507],"Mechanical circulatory support","High-Risk Percutaneous Coronary Intervention","Coronary artery disease","2025-08-29",{"date":510,"type":32},"2025-09-08",{"date":512,"type":32},"2023-02-17",{"date":514,"type":21},"2029-02-17",{"name":516,"class":324},"National Medical Research Center for Cardiology, Ministry of Health of Russian Federation",{"id":518,"slug":519,"hasResults":12,"nctId":520,"briefTitle":521,"officialTitle":521,"acronym":522,"eligibilityCriteria":523,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":524,"targetDuration":4,"studyType":50,"phases":526,"briefSummary":527,"conditions":528,"keywords":529,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":533,"lastUpdatePostDateStruct":534,"startDateStruct":536,"completionDateStruct":538,"leadSponsor":540,"locationsCount":541},"100600622","simple-urine-composition-based-personalized-algorithm-for-effective-congestion-relief-in-decompensated-heart-failure-100600622","NCT07099885","Simple Urine Composition-based Personalized Algorithm for Effective Congestion Relief in Decompensated Heart Failure","SAFER-DHF","Inclusion Criteria:\n\n* Adult patients over 18 years of age who provide informed consent\n* Ability to enroll in the study within the first 24 hours of hospitalization\n* Primary reason for hospitalization is acute heart failure with signs of congestion (at least moderate lower extremity edema)\n* NT-proBNP \\> 1500 pg\u002Fml\n* Anticipated need for diuretic therapy for at least 48 hours from the time of study enrollment\n\nExclusion Criteria:\n\n* End-stage kidney disease requiring renal replacement therapy\n* Hemodynamic instability requiring inotropic support\n* Active infection requiring intravenous antibiotic therapy",{"count":525,"type":21},90,[52],"The aim of this study is to evaluate the effectiveness of loop diuretic adaptative algorithm that is based on machine learning, urine output prediction tool, in decongestion of acute heart failure patients.\n\nA total of 90 patients will be enrolled in the study. Of these, 45 will be assigned to the algorithm-based intervention group, while the remaining 45 will serve as the control group. In the control group, all decisions regarding diuretic therapy will be made solely by the attending physician, without the use of the algorithm.\n\nPatients will receive intravenous furosemide, with the initial dose determined by the attending physician. Two hours after administration of the diuretic, a spot urine sample will be collected to measure sodium and creatinine concentrations. Based on these values, the 6-hour urine output will be estimated using the machine learning, urine output prediction tool (http:\u002F\u002Fdiuresis.umw.edu.pl). This estimate will guide the diuretic therapy plan for the first 24 hours of hospitalization. On the second day, the procedure will be repeated using the same methodology.",[26,276],[530,531,532,141],"decongestion","diuretics","algorithm","2025-08-06",{"date":535,"type":32},"2025-08-12",{"date":537,"type":32},"2025-08-01",{"date":539,"type":21},"2027-01-31",{"name":178,"class":39},2,{"id":543,"slug":544,"hasResults":12,"nctId":545,"briefTitle":546,"officialTitle":546,"acronym":547,"eligibilityCriteria":548,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":467,"enrollmentInfo":549,"targetDuration":4,"studyType":50,"phases":551,"briefSummary":552,"conditions":553,"keywords":555,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":559,"lastUpdatePostDateStruct":560,"startDateStruct":562,"completionDateStruct":563,"leadSponsor":565,"locationsCount":209},"100561832","vietnamese-rapid-acceleration-protocol-for-intensifying-drug-therapy-in-heart-failure-with-reduced-ejection-fraction-100561832","NCT06595290","Vietnamese Rapid Acceleration Protocol for Intensifying Drug Therapy in Heart Failure With Reduced Ejection Fraction","VN-RAPID","Inclusion Criteria:\n\n1. Hospital admission with diagnosis of acute heart failure assessed by clinical signs and symptoms of congestion and radiographic, biological tests (if admitted with acute coronary syndrome, required at least Killip class II or clear evidence of congestion on admission assessed by chest x-ray or lung ultrasound and\u002For pulmonary congestion requiring intravenous treatment)\n2. Female or male patients ≥ 18 years old\n3. At randomization:\n\n   1. Systolic blood pressure \\> 90 mmHg (at least 2 measurements on 2 different occasions) and\n   2. Heart rate ≥ 60 bpm (at least 2 measurements on 2 different occasions) and\n   3. Serum potassium ≤ 5.0 mmol\u002FL\n4. Left ventricular ejection fraction (LVEF) ≤ 40% assessed locally by Simpson's Biplane method via echocardiography (if multiple LVEF measurements, the last one performed prior to randomization should be considered as the qualifying measurement)\n5. Persistent congestion at the time of randomization with pre-discharge NT-proBNP ≥ 1500 ng\u002FL\n6. HFrEF medications at randomization:\n\n   1. ≤ ¼ RASi\u002FARNi target dose and\n   2. ≤ ¼ beta-blocker target dose and\n   3. ≤ ½ MRA dose\n7. Obtained written informed consent form\n\nExclusion Criteria:\n\n1. Clearly documented intolerance to high doses of RASi\u002FARNi or beta-blockers\n2. Absolute contraindication to usage of RASi\u002FARNi or beta-blocker or MRA or SGLT2i as per ESC 2021\u002FACC 2022 Heart failure guideline\n3. LVEF \\>40% assessed by echocardiography on the latest measurement prior to discharge\n4. Renal disease or eGFR \\< 30 mL\u002Fmin\u002F1.73m2 (as estimated by the CKD-EPI 2021 or the simplified MDRD) at Screening or history of dialysis.\n5. Significant pulmonary disease contributing substantially to the patients' dyspnea such as FEV1\\< 1 liter or need for chronic systemic or nonsystemic steroid therapy, or any kind of primary right heart failure such as primary pulmonary hypertension or recurrent pulmonary embolism.\n6. Implantation of cardiac resynchronization device or underwent coronary artery bypass graft surgery within 3 months\n7. Myocardial infarction, unstable angina or cardiac surgery within 3 months, or cardiac resynchronization therapy (CRT) device implantation within 3 months, or percutaneous coronary intervention (PCI), within 1 month prior to Screening.\n8. AHF triggered primarily by a correctable etiology such as significant arrhythmia (e.g., sustained ventricular tachycardia, or atrial fibrillation\u002Fflutter with sustained ventricular response \\>130 beats per minute, or bradycardia with sustained ventricular arrhythmia \\<45 beats per minute), infection, severe anemia, pulmonary embolism, exacerbation of COPD, planned admission for device implantation or severe non-adherence leading to very significant fluid accumulation prior to admission and brisk diuresis after admission. Troponin elevations without other evidence of an acute coronary syndrome are not an exclusion.\n9. Uncorrected thyroid disease, active myocarditis, or known amyloid or hypertrophic obstructive cardiomyopathy.\n10. History of heart transplant or on a transplant list, or using or planned to be implanted with a ventricular assist device.\n11. Sustained ventricular arrhythmia with syncopal episodes within the 3 months prior to screening that is untreated.\n12. Presence at Screening of any hemodynamically significant valvular stenosis or regurgitation, except mitral or tricuspid regurgitation secondary to left ventricular dilatation, or the presence of any hemodynamically significant obstructive lesion of the left ventricular outflow tract.\n13. Active infection at any time during the AHF hospitalization prior to Randomization based on abnormal temperature and elevated WBC or need for intravenous antibiotics.\n14. Stroke or TIA within the 3 months prior to Screening.\n15. Primary liver disease considered to be life threatening.\n16. Psychiatric or neurological disorder, cirrhosis, or active malignancy leading to a life expectancy \\< 6 months.\n17. Prior (defined as less than 30 days from screening) or current enrollment in a CHF trial or participation in an investigational drug or device study within the 30 days prior to screening\n18. Discharge for the AHF hospitalization anticipated to be \\> 14 days from admission, or to a long-term care facility. Randomization must occur within 12 days following admission and at within 2 days prior to anticipated discharge.\n19. Inability to comply with all study requirements, due to major comorbidities, social or financial issues, or a history of noncompliance with medical regimens, that might compromise the patient's ability to understand and\u002For comply with the protocol instructions or follow-up procedures\n20. Pregnant or nursing (lactating) women.",{"count":550,"type":21},500,[52],"VN-RAPID is an open-label, multicenter, randomized controlled trial evaluating the safety and efficacy of in-hospital initiation and rapid up-titration of four-pillar therapy for hospitalized Asian patients with acute heart failure (AHF) and reduced ejection fraction (HFrEF). The study compares a standardized protocol of intensified treatment (high-intensity care arm) with usual care in patients with elevated NT-proBNP levels who are not on optimal HFrEF medications. The high-intensity care arm involves initiation of all four pillars of HFrEF therapy (RAS inhibitor, beta-blocker, MRA, and SGLT2i) before discharge, followed by a structured 6-week outpatient up-titration process with frequent follow-ups. The study aims for 75% of target doses for RAS inhibitors and beta-blockers, considering the lower blood pressure tendency in Asian populations. Participants will be followed for 180 days to assess clinical outcomes.",[26,554],"Acute Heart Failure With Reduced Ejection Fraction",[556,557,251,558],"HFrEF","STRONG-HF","Rapid uptitration","2025-07-31",{"date":561,"type":32},"2025-08-05",{"date":537,"type":32},{"date":564,"type":21},"2029-01-01",{"name":566,"class":39},"University Medical Center Ho Chi Minh City (UMC)",{"id":568,"slug":569,"hasResults":12,"nctId":570,"briefTitle":571,"officialTitle":572,"acronym":4,"eligibilityCriteria":573,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":574,"targetDuration":4,"studyType":23,"phases":4,"briefSummary":575,"conditions":576,"keywords":578,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":582,"lastUpdatePostDateStruct":583,"startDateStruct":585,"completionDateStruct":587,"leadSponsor":589,"locationsCount":69},"100592422","evaluating-residual-congestion-at-discharge-in-acute-heart-failure-patients-100592422","NCT06993220","Evaluating Residual Congestion at Discharge in Acute Heart Failure Patients","Multiparametric Assessment of Residual Congestion at Discharge in Patients With Acute Heart Failure","Inclusion Criteria:\n\n* Age ≥ 18 years.\n* Patients hospitalized for new onset heart failure or worsening heart failure defined by:\n\n  1. Symptoms classified as New York Heart Association class III or IV.\n  2. Clinical or instrumental signs of volume overload (e.g., dyspnea with evidence of pulmonary congestion on X-rays or lung ultrasound, pitting edema, and jugular venous distension).\n  3. Elevated NT-proBNP levels within the first 24 hours of admission (cutoff values: 450 ng\u002FL for patients \\\u003C 50 years; \\>900 ng\u002FL for patients aged 50-75 years; \\>1800 ng\u002FL for patients \\>75 years).\n* Ability to provide informed consent.\n\nExclusion Criteria:\n\n* Known diagnosis of septicemia.\n* Glomerular filtration rate \\\u003C 15 ml\u002Fmin.\n* Life expectancy \\\u003C 6 months.\n* Active myocarditis.\n* Heart transplant recipients.\n* Patients with ventricular assist devices.\n* Congenital heart diseases.\n* Moderate-to-severe liver disease (Child-Pugh B-C).\n* Patients that will not be followed up by the Heart Failure Unit.",{"count":550,"type":21},"Treatment of congestion is one of the main goals in patients hospitalized for acute heart failure. Nevertheless, current evidence shows that decongestion is often not achieved and that residual congestion at discharge is strongly associated with poor outcomes. While this association has been demonstrated, previous studies have primarily focused on single parameters of congestion (physical examination, biomarkers, or imaging features). The aim of the study is to assess residual congestion at discharge using a multiparametric approach and to compare the prognostic value of each evaluation strategy. Additionally, the analysis will be supported by artificial intelligence to develop a multiparametric prognostic algorithm that can provide an improved predictive model compared to standard statistical approaches.",[26,577],"Congestive Heart Failure(CHF)",[141,579,580,581],"residual congestion","multiparametric assessment","risk stratification","2025-07-15",{"date":584,"type":32},"2025-07-18",{"date":586,"type":32},"2025-01-01",{"date":588,"type":21},"2027-01-01",{"name":590,"class":39},"Consorci Sanitari Integral",{"id":592,"slug":593,"hasResults":12,"nctId":594,"briefTitle":595,"officialTitle":596,"acronym":597,"eligibilityCriteria":598,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":599,"targetDuration":4,"studyType":50,"phases":601,"briefSummary":602,"conditions":603,"keywords":604,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":610,"lastUpdatePostDateStruct":611,"startDateStruct":613,"completionDateStruct":615,"leadSponsor":617,"locationsCount":618},"100566326","phase-2-exogenous-ketone-supplements-in-patients-hospitalized-for-acute-heart-failure-100566326","NCT06653725","Exogenous KETOne Supplements in Patients Hospitalized for Acute Heart Failure","Exogenous KETOne Supplements in Patients Hospitalized for Acute Heart Failure. A Randomized Clinical Trial (KETO-AHF)","KETO-AHF","The study will enroll adult patients (≥18 years) admitted with AHF as the primary diagnosis, meeting all the following criteria:\n\n1. Documented new or worsening symptoms due to heart failure with at least one of the following: persistent dyspnea at rest or with minimal exertion, or fatigue.\n2. Objective evidence of worsening heart failure, consisting of at least two physical examination findings consistent with fluid retention and\u002For end-organ hypoperfusion or one physical examination finding and at least one laboratory criterion:\n\n   a) Physical examination findings considered to be due to heart failure, including new or worsened: i. Peripheral edema ii. Increasing abdominal distention or ascites (in the absence of primary hepatic disease) iii. Pulmonary rales\u002Fcrackles\u002Fcrepitations iv. Increased jugular venous pressure and\u002For hepatojugular reflux v. S3 gallop vi. Clinically significant or rapid weight gain thought to be related to fluid retention b) Laboratory evidence of worsening HF, if obtained within 24 hours of presentation, including: i. Increased B-type natriuretic peptide (BNP) \u002F N-terminal pro-BNP (NT-proBNP) concentrations consistent with decompensation of heart failure. In patients with chronically elevated natriuretic peptides, an increase of \\>30% above baseline should be noted.\n\n   ii. Radiological evidence of pulmonary congestion iii. Echocardiographic criteria include: Dilated inferior vena cava with minimal collapse on inspiration; decreased left ventricular outflow tract (LVOT) minute stroke distance (velocity time integral \\[VTI\\]); septal or lateral E\u002Fe' \\>15 or \\>12, respectively; D-dominant pulmonary venous inflow pattern.\n\n   iv. Invasive diagnostic evidence with right heart catheterization showing a pulmonary capillary wedge pressure ≥18 mmHg, central venous pressure ≥12 mmHg, or a cardiac index \\<2.2 L\u002Fmin\u002Fm2\n3. Treatment with at least 40 mg of intravenous furosemide or its equivalent and\u002For intravenous vasoactive drugs and\u002For inotropic drugs.\n4. An LVEF of ≤35% is required, measured during the present hospitalization.\n5. Participants must present with elevated levels of natriuretic peptides, specifically NT-proBNP ≥600 pg\u002FmL or BNP ≥150 pg\u002FmL. For those in atrial fibrillation at the time of inclusion, NT-proBNP levels must be ≥900 pg\u002FmL or BNP ≥225 pg\u002FmL.\n\nThe enrollment window extends to the first five days of the hospital stay.\n\nExclusion Criteria:\n\n1. Current hospitalization for AHF triggered by significant arrhythmia (atrial fibrillation\u002Fflutter with sustained ventricular response \\>110 beats per minute, clinically significant bradycardia, or sustained ventricular tachycardia)\n2. Cardiogenic shock in INTERMACS level 1 or 2 (i.e. unstable hemodynamics despite inotropic\u002Fvasopressor therapy)\n3. Likelihood or current use of mechanical circulatory support\n4. Recent cardiac surgery within 3 days\n5. Ongoing severe infection or sepsis, severe anemia, acute exacerbation of chronic obstructive pulmonary disease, pulmonary embolism, or cerebrovascular accident\n6. Significant primary valvular disease (hemodynamically severe uncorrected primary cardiac valvular disease)\n7. Planned implantation of a cardiac resynchronization therapy device\n8. eGFR \\<15 mL\u002Fmin\u002F1.73 m2 during current hospitalization (unless ongoing continuous renal replacement therapy) or recurring dialysis\n9. Known obstructive hypertrophic cardiomyopathy, congenital heart disease, acute mechanical cause of acute heart failure (e.g., papillary muscular rupture), acute myocarditis, or constrictive pericarditis according to the treating physician\n10. Type 1 diabetes\n11. Advanced liver disease (Child-Pugh class C)\n12. Dementia or other cognitive disorder making the patient unable to give informed consent\n13. Pregnancy or breastfeeding\n14. Inability to intake oral substances or severe dysphagia\n15. Significant gastrointestinal disease (i.e. severe inflammatory bowel disease or gastric ulcer)\n16. Adherent to a ketogenic diet within 30 days of enrollment\n17. Awaiting cardiac transplantation\n18. Very severe lung disease and\u002For treatment with continuous home oxygen therapy\n19. Major comorbidity, medical condition, or health issue that, according to the investigator's judgment, would hinder the participant's capacity to engage in or successfully finish the study",{"count":600,"type":21},250,[438],"This is a multicenter, randomized, double-blind, placebo-controlled trial to investigate the clinical efficacy of treatment with exogenous dietary ketone supplement containing 1,3-butanediol in patients hospitalized with acute heart failure (AHF), potentially leading to better clinical outcomes.",[26],[251,605,310,606,607,608,609],"Ketone supplements","3-hydroxybutyrate","1,3-butanediol","six-minute walk test","win ratio","2025-06-04",{"date":612,"type":32},"2025-06-05",{"date":614,"type":32},"2025-03-20",{"date":616,"type":21},"2028-01-01",{"name":38,"class":39},8,{"id":620,"slug":621,"hasResults":12,"nctId":622,"briefTitle":623,"officialTitle":623,"acronym":624,"eligibilityCriteria":625,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":626,"targetDuration":4,"studyType":50,"phases":628,"briefSummary":629,"conditions":630,"keywords":632,"overallStatus":200,"whyStopped":4,"lastUpdateSubmitDate":636,"lastUpdatePostDateStruct":637,"startDateStruct":639,"completionDateStruct":641,"leadSponsor":643,"locationsCount":69},"100578534","phase-4-efficacy-and-safety-of-early-initiation-of-vericiguat-in-heart-failure-after-acute-myocardial-infarction-100578534","NCT06812546","Efficacy and Safety of Early Initiation of Vericiguat in Heart Failure After Acute Myocardial Infarction","VIC-MI","Inclusion Criteria:\n\n* Age ≥ 18 years old\n* Undertaking revascularization for criminal coronary artery during hospitalization\n* Acute heart failure occurs within 14 days in hospital after STEMI or NSTEMI, meeting all of the following criteria: typical symptoms or signs of heart failure; Treatment with oral or intravenous diuretics is required; LVEF measured by echocardiography is ≤ 45%; Elevated levels of NT proBNP in patients with sinus rhythm ≥ 1000pg\u002Fml and atrial fibrillation\u002Fflutter ≥ 1600pg\u002Fml\n* eGFR ≥ 15 ml\u002Fmin\u002F1.73m2\n* Informed consent has to be given in written form\n\nExclusion Criteria:\n\n* Plan to undergo staged revascularization or if the criminal coronary artery has not been successfully opened\n* Severe and uncontrolled lung diseases, such as newly developed pulmonary embolism, primary pulmonary hypertension, acute exacerbation of COPD, etc\n* Severe liver and kidney dysfunction, Child Pugh grade C or eGFR \\\u003C 15ml\u002Fmin\u002F1.73m2\n* Allergies to ACEI, ARB, ARNI, beta blockers, SGLT2i, MRA, Vericiguat, and other medications\n* Symptomatic hypotension or systolic blood pressure less than 90mmHg after discontinuing intravenous medication\n* Women in the perinatal period or those planning to conceive\n* Patients planning to undergo elective surgical treatment or tumor chemotherapy\n* Diagnosed as Takotsubo cardiomyopathy or nonobstructive acute myocardial infarction (MINOCA)\n* Previous diagnosis of cardiomyopathy, including but not limited to dilated cardiomyopathy, hypertrophic cardiomyopathy, etc.\n* Autoimmune disease or infectious diseases with typical cardiovascular damage, such as syphilis, systemic lupus erythematosus, etc.\n* Diagnosed with severe heart valve disease",{"count":627,"type":21},200,[110],"Heart failure (HF) is a severe cardiovascular disease with extremely high morbidity and mortality rates worldwide, and ischemic cardiomyopathy is an important cause of heart failure. Vericiguat is a soluble guanylate cyclase stimulator which has been verified to improve the cardiovascular outcomes in heart failure patients. The VICTORIA trial excluded patients with acute coronary syndrome in 3 months prior to the study start, so it is still unclear about the efficacy and safety of vericiguat in heart failure after acute myocardial infarction. So we conducted this multi-center, prospective, cohort study to estimate the efficacy and safety of vericiguat in HF patients after acute myocardial infarction.",[84,631,26],"Acute Myocardial Infarction (AMI)",[633,634,84,635],"Vericiguat","Guideline-Directed Medical Therapy","Acute myocardial infarction","2025-02-02",{"date":638,"type":32},"2025-02-06",{"date":640,"type":21},"2025-04-01",{"date":642,"type":21},"2026-12-30",{"name":644,"class":39},"Dongying Zhang",{"id":646,"slug":647,"hasResults":12,"nctId":648,"briefTitle":649,"officialTitle":649,"acronym":650,"eligibilityCriteria":651,"healthyVolunteers":12,"sex":17,"minAge":467,"maxAge":4,"enrollmentInfo":652,"targetDuration":4,"studyType":23,"phases":4,"briefSummary":654,"conditions":655,"keywords":657,"overallStatus":200,"whyStopped":4,"lastUpdateSubmitDate":661,"lastUpdatePostDateStruct":662,"startDateStruct":664,"completionDateStruct":666,"leadSponsor":668,"locationsCount":4},"100569299","acute-heart-failure-in-elderly-patients-admitted-to-the-emergency-department-with-acute-dyspnea-a-multimarker-approach-prognostic-study-100569299","NCT06692439","Acute Heart Failure in Elderly Patients Admitted to the Emergency Department with Acute Dyspnea: a Multimarker Approach Prognostic Study","READ-MA-PRONO","Inclusion Criteria: Patients aged ≥75 years from the READ cohort (NCT04240067) who:\n\n1. Present to the ED with acute dyspnea meeting at least two criteria:\n\n   * Respiratory rate ≥25\u002Fmin\n   * PaO2 ≤70 mmHg\n   * SpO2 ≤92% on room air\n   * PaCO2 ≥45 mmHg and pH ≤7.35\n   * Oxygen requirement\n2. Have confirmed AHF diagnosis by two expert reviewers based on clinical data, laboratory results (excluding NT-proBNP), ECG, imaging, and specialized cardiac echo\n3. Provided written consent for data use in the READ-MA-PRONO study\n\nExclusion Criteria:\n\n* No written consent for data use in the READ-MA-PRONO study",{"count":653,"type":21},185,"Background and Rationale:\n\nAcute dyspnea is a frequent presenting symptom in emergency departments (ED), with acute heart failure (AHF) being the most common cause leading to hospitalization in elderly patients. AHF in this population presents unique challenges in diagnosis, management, and risk stratification. Current tools for severity assessment and risk stratification (NT-proBNP and echocardiography) have shown limited evolution over the past 20 years and remain insufficient, particularly for elderly patients who predominantly present with heart failure with preserved ejection fraction (HFpEF). Recent European Society of Cardiology (ESC) and American Heart Association (AHA) guidelines specifically call for research on biomarkers within a multi-marker strategy for AHF risk stratification.\n\nResearch Hypothesis:\n\nThe study hypothesizes that a combination of biomarkers (NT-proBNP, High-sensitivity Troponin I, ST2, Galectin-3, CD146 and suPAR) will provide prognostic value and effectively stratify risk for early outcomes (90-day mortality and hospital readmission) in patients aged ≥75 years presenting to the ED with acute dyspnea and diagnosed with AHF.\n\nPrimary Objective:\n\nTo evaluate the prognostic value of six biomarkers, both individually and in combination, for predicting 90-day all-cause mortality or ED readmission in elderly patients (≥75 years) presenting with acute dyspnea and diagnosed with AHF.\n\nStudy Design:\n\nThis is a prospective prognostic study including patients from 7 emergency departments from university and non-university hospitals in France.\n\nStudy Population:\n\n(I) Patients aged ≥75 years presenting to the ED with acute dyspnea meeting at least two criteria:\n\n* Respiratory rate ≥25\u002Fmin\n* PaO2 ≤70 mmHg\n* SpO2 ≤92% on room air\n* PaCO2 ≥45 mmHg and pH ≤7.35\n* Oxygen requirement\n\n(ii) Have confirmed AHF diagnosis by two expert reviewers based on clinical data, laboratory results (excluding NT-proBNP), ECG, imaging, and specialized cardiac echo\n\nPrimary Endpoint:\n\nComposite endpoint of 90-day all-cause mortality or ED readmission, as recommended by the ESC for evaluating early outcomes in AHF patients.\n\nAnalysis plan includes:\n\n* ROC curves for optimal biomarker thresholds\n* Kaplan-Meier survival analysis with log-rank tests\n* Univariate and multivariate Cox regression analyses\n* Bootstrap methods for confidence intervals",[26,656],"Dyspnoea",[141,658,659,660],"dyspnea","prognosis","biomarkers","2024-11-14",{"date":663,"type":32},"2024-11-18",{"date":665,"type":21},"2024-11",{"date":667,"type":21},"2025-09",{"name":486,"class":39},{"id":670,"slug":671,"hasResults":12,"nctId":672,"briefTitle":673,"officialTitle":674,"acronym":675,"eligibilityCriteria":676,"healthyVolunteers":12,"sex":17,"minAge":677,"maxAge":4,"enrollmentInfo":678,"targetDuration":680,"studyType":23,"phases":4,"briefSummary":681,"conditions":682,"keywords":688,"overallStatus":200,"whyStopped":4,"lastUpdateSubmitDate":694,"lastUpdatePostDateStruct":695,"startDateStruct":697,"completionDateStruct":699,"leadSponsor":701,"locationsCount":69},"100567586","exploring-the-correlations-of-lung-ultrasound-with-delirium-and-outcomes-in-acute-geriatrics-world-a-multicenter-prospective-observational-study-from-the-greta-group-of-the-italian-society-of-gerontology-and-geriatrics-100567586","NCT06670118","Exploring the Correlations of Lung Ultrasound with Delirium and Outcomes in Acute GEriatrics World: a Multicenter, Prospective, Observational Study from the GRETA Group of the Italian Society of Gerontology and Geriatrics","EXPLORING the CORRELATION of the LUNG ULTRASOUND with DELIRIUM and OUTCOMES in ACUTE GERIATRICS WORLD (ECO-AGE): a MULTICENTER, PROSPECTIVE, OBSERVATIONAL STUDY from the GRETA GROUP (GRUPPO DI RICERCA in ECOGRAFIA TORACICA NELL' ANZIANO) of the ITALIAN SOCIETY of GERONTOLOGY and GERIATRICS (SIGG)","ECO-AGE","Inclusion Criteria:\n\n* Patients aged 65 years or older, admitted directly from the Emergency Room or Emergency Medical Services with acute respiratory symptoms or signs.\n\nPresence of acute respiratory symptoms, including:\n\n* Dyspnea or cough.\n* Oxygen saturation less than 94% or respiratory rate ≥ 22 breaths per minute, or PaO2\u002FFiO2 \\\u003C 300.\n* Clinical suspicion of acute respiratory illness (e.g., pneumonia, acute congestive heart failure, pulmonary edema, COPD, pleural effusion, pneumothorax).\n* Lung ultrasound (LUS) performed within 48 hours of admission for clinical reasons.\n* Signed informed consent for participation in the study.\n\nExclusion Criteria:\n\n* Presence of delirium upon admission.\n* Refusal to sign the informed consent form or consent to data collection.\n* Terminal illness with an estimated survival prognosis of no more than 3 months.\n* Previous open thoracic or cardiothoracic surgery compromising the quality of LUS images.\n* Lack of cooperation during the LUS examination.\n* Any condition determined by the investigators that could introduce bias into the study or compromise the quality of the LUS examination.","65 Years",{"count":679,"type":21},480,"3 Months","The purpose of this observational study is to investigate the prognostic relevance of lung ultrasound (LUS) performed on older patients (aged 65 and above) admitted to the hospital with acute respiratory symptoms. The primary objective is to determine if LUS-detected pulmonary abnormalities upon hospital admission are associated with the development of delirium during hospitalization. Secondary objectives include assessing the association between LUS patterns and clinical outcomes such as oxygen supplementation duration, non-invasive ventilation use, mortality, and length of hospital stay. This study involves no interventions and will monitor patients using LUS as part of their regular clinical care in multiple centers.",[683,684,685,26,686,687],"Acute Respiratory Failure","Delirium in Old Age","Pneumonia","Chronic Obstructive Pulmonary Disease (COPD)","Ultrasound Exams",[689,690,691,692,693],"Lung Ultrasound Abnormalities in Older Adults","Lung ultrasound","delirium","respiratory failure","geriatrics","2024-10-31",{"date":696,"type":32},"2024-11-01",{"date":698,"type":21},"2024-12-01",{"date":700,"type":21},"2026-12-01",{"name":702,"class":39},"University of Milano Bicocca"]