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Effect of a Therapeutic Strategy Guided by Lung Ultrasound on 6-Month Outcomes in Patients with Heart Failure: Randomized, Multicenter Trial (EPICC Study)

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Abstract

Introduction and Objectives

Pulmonary congestion (PC) is associated with an increased risk of hospitalization and death in patients with heart failure (HF). Lung ultrasound has shown to be highly sensitive for detecting PC in HF. The aim of this study is to evaluate whether lung ultrasound–guided therapy improves 6-month outcomes in patients with HF compared with conventional treatment.

Materials and Methods

Randomized, multicenter, single-blind clinical trial in patients discharged from Internal Medicine Departments after hospitalization for decompensated HF. Participants will be assigned 1:1 to receive treatment guided according to the presence of lung ultrasound signs of congestion (semi-quantitative evaluation of B lines and the presence of pleural effusion) versus clinical assessment of congestion. The primary outcome is the combination of cardiovascular death and readmission for HF at 6 months.

Conclusions

The results of this study will provide more evidence about the impact of lung ultrasound on treatment monitoring in patients with chronic HF.

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Acknowledgments

We would like to acknowledge the Spanish National Society of Internal Medicine for supporting this study as well as the working groups for Heart Failure and Clinical Ultrasound. Thanks also go to Dr. Juan Ignacio Pérez-Calvo and Dr. Juan José Granizo for their methodological help.

Funding

This study was partially supported by grants from the Instituto de Salud Carlos III supported with funds from the Spanish Ministry of Health and FEDER (PI15/00773, and PI18/00456).

Author information

Authors and Affiliations

  1. Internal Medicine Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IDISSC), Facultad de Medicina, Universidad Complutense, Avda. Prof. Martin Lago S/N, 28040, Madrid, Spain

    Manuel Méndez Bailón & Elpidio Calvo Manuel

  2. Internal Medicine Department, Hospital Vega Baja, Orihuela, Spain

    Jose María Cepeda Rodrigo

  3. Internal Medicine Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France

    Noel Lorenzo-Villalba

  4. Internal Medicine Department, Hospital Universitario Lucus Augusti, Lugo, Spain

    Jose Manuel Cerqueiro

  5. Internal Medicine Department, Hospital Universitario La Princesa, Madrid, Spain

    Jose Curbelo García

  6. Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain

    Francisco Javier Martín-Sánchez

  7. Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain

    Ramon Bover Freire

  8. Internal Medicine Department, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain

    Pilar Cubo Romano, Jose Manuel Casas Rojo & Juan Torres Macho

  9. Internal Medicine Department, Hospital Universitario Ramón y Cajal, Madrid, Spain

    Luis Manzano Espinosa

  10. Internal Medicine Department, Hospital de Zafra, Zafra, Badajoz, Spain

    Jose Carlos Arévalo-Lorido

Authors
  1. Manuel Méndez Bailón
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  11. Jose Carlos Arévalo-Lorido
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  13. Juan Torres Macho
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Consortia

Spanish Study Groups of Heart Failure and Clinical Echography of the Spanish National Society of Internal Medicine

Corresponding author

Correspondence to Manuel Méndez Bailón.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All the procedures involving human participants performed in this study are in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki.

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Bailón, M.M., Rodrigo, J.M.C., Lorenzo-Villalba, N. et al. Effect of a Therapeutic Strategy Guided by Lung Ultrasound on 6-Month Outcomes in Patients with Heart Failure: Randomized, Multicenter Trial (EPICC Study). Cardiovasc Drugs Ther 33, 453–459 (2019). https://doi.org/10.1007/s10557-019-06891-z

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  • DOI: https://doi.org/10.1007/s10557-019-06891-z

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