NCT07469722
POcus INTERvention for Tailoring Diuretic Strategy in Acute Decompensated Heart Failure
Not Yet Recruiting · Phase 2, Phase 3 · Hospital de Clinicas de Porto Alegre · registry updated 2026-03-18
Inclusion and exclusion lines below are quoted from ClinicalTrials.gov. No match score is shown, because a score needs a person's age, biomarkers, and treatment dates. Confirm the record with the study team.
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....
Inclusion
- Men or women aged 18 years or older.
- Diagnosis of acute decompensated heart failure (ADHF) with left ventricular ejection fraction \<50%, presenting with symptoms (dyspnea, orthopnea, fatigue) and/or signs (pulmonary crackles, peripheral edema, jugular venous distension, hepatomegaly, hepatojugular reflux) of decompensated heart failure.
- Brain natriuretic peptide (BNP) ≥ 300 pg/mL.
- Signs of systemic and/or pulmonary congestion on POCUS, defined as DUCS ≥ 3 points.
- Time from hospital admission ≤ 48 hours.
- Signed informed consent.
Exclusion
- Patients under evaluation for heart transplantation or with prior heart transplantation.
- Acute coronary syndrome as the primary cause of hospitalization.
- Evidence of uncontrolled infection.
- Cardiac surgery or percutaneous coronary or structural cardiac intervention within the previous 30 days.
- Signs of hypoperfusion, defined as any of the following: mean arterial pressure \< 60 mmHg, capillary refill time \> 4 seconds, arterial lactate \> 2 mmol/L or venous lactate \> 2.5 mmol/L.
- Acute pulmonary embolism (segmental or more proximal) as the primary cause of hospitalization.