Continuous ultrafiltration for congestive heart failure: The CUORE trial

Giancarlo Marenzi, Manuela Muratori, Eugenio R. Cosentino, Elisa R. Rinaldi, Valeria Donghi, Valentina Milazzo, Emiliana Ferramosca, Claudio Borghi, Antonio Santoro, Piergiuseppe Agostoni

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Abstract

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 = 29) or ultrafiltration (ultrafiltration group; n = 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 ± 4.5 and 7.9 ± 5.0 kg, respectively; P = .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 = .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 = .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.

Original languageEnglish
JournalJournal of Cardiac Failure
Volume20
Issue number5
Publication statusPublished - 2014

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Keywords

  • Congestion
  • diuretics
  • heart failure
  • ultrafiltration

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Marenzi, G., Muratori, M., Cosentino, E. R., Rinaldi, E. R., Donghi, V., Milazzo, V., Ferramosca, E., Borghi, C., Santoro, A., & Agostoni, P. (2014). Continuous ultrafiltration for congestive heart failure: The CUORE trial. Journal of Cardiac Failure, 20(5).