- 作者：Giancarlo Marenzi ; Manuela Muratori ; Eugenio R. Cosentino ; Elisa R. Rinaldi ; Valeria Donghi ; Valentina Milazzo ; Emiliana Ferramosca ; Claudio Borghi ; Antonio Santoro ; Piergiuseppe Agostoni
- 关键词：Congestion ; ultrafiltration ; diuretics ; heart failure
- 刊名：Journal of Cardiac Failure
- 出版年：January, 2014
- 年：2014
- 卷：20
- 期：1
- 页码：9-17
- 全文大小：427 K
Background
There are limited data comparing ultrafiltration with standard medical therapy as first-line treatment in patients with severe congestive heart failure (HF). We compared ultrafiltration and conventional therapy in patients hospitalized for HF and overt fluid overload.Methods and Results
Fifty-six patients with congestive HF were randomized to receive standard medical therapy (control group; n聽= 29) or ultrafiltration (ultrafiltration group; n聽= 27). The primary end point of the study was rehospitalizations for congestive HF during a 1-year follow-up. Despite similar body weight reduction at hospital discharge in the 2 groups (7.5 卤 5.5 and 7.9 卤 9.0 kg, respectively; P聽= .75), a lower incidence of rehospitalizations for HF was observed in the ultrafiltration-treated patients during the following year (hazard ratio 0.14, 95% confidence interval 0.04-0.48; P聽= .002). Ultrafiltration-induced benefit was associated with a more stable renal function, unchanged furosemide dose, and lower B-type natriuretic peptide levels. At 1 year, 7 deaths (30%) occurred in the ultrafiltration group and 11 (44%) in the control group (P聽= .33).
Conclusions
In HF patients with severe fluid overload, first-line treatment with ultrafiltration is associated with a prolonged clinical stabilization and a greater freedom from rehospitalization for congestive HF.