Effects of ULTRAfiltration vs. DIureticS on clinical, biohumoral and haemodynamic variables in patients with deCOmpensated heart failure: The ULTRADISCO study

Cristina Giglioli, Daniele Landi, Emanuele Cecchi, Marco Chiostri, Gian Franco Gensini, Serafina Valente, Mauro Ciaccheri, Gabriele Castelli, Salvatore Mario Romano

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

AimsTo evaluate the clinical, biohumoral, and haemodynamic effects of ultrafiltration vs. intravenous diuretics in patients with decompensated heart failure (HF). Signs and symptoms of volume overload are often present in these patients and standard therapy consists primarily of intravenous diuretics. Increasing evidence suggests that ultrafiltration can be an effective alternative treatment.Methods and resultsThirty patients with decompensated HF were randomly assigned to diuretics or ultrafiltration. Haemodynamic variables, including several novel parameters indicating the overall performance of the cardiovascular system, were continuously assessed with the Pressure Recording Analytical Method before, during, at the end of treatment (EoT) and 36 h after completing treatment. Aldosterone and N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma levels were also measured. Patients treated with ultrafiltration had a more pronounced reduction in signs and symptoms of HF at EoT compared with baseline, and a significant decrease in plasma aldosterone (0.24 ± 0.25 vs. 0.86 ± 1.04 nmol/L; P <0.001) and NT-proBNP levels (2823 ± 2474 vs. 5063 ± 3811 ng/L; P <0.001) compared with the diuretic group. The ultrafiltration group showed a significant improvement ( of baseline) in a number of haemodynamic parameters, including stroke volume index (114.0 ± 11.7; P <0.001), cardiac index (123.0 ± 20.8; P <0.001), cardiac power output (114.0 ± 13.8; P <0.001), dP/dtmax (129.5 ± 19.9; P <0.001), and cardiac cycle efficiency (0.24 ± 0.54 vs. -0.14 ± 0.50 units; P <0.05), and a significant reduction in systemic vascular resistance 36 h after the treatment (88.0 ± 10.9; P <0.001), which was not observed in the diuretic group.ConclusionsIn patients with advanced HF, ultrafiltration facilitates a greater clinical improvement compared with diuretic infusion by ameliorating haemodynamics (assessed using a minimally invasive methodology) without a marked increase in aldosterone or NT-proBNP levels.

Original languageEnglish
Pages (from-to)337-346
Number of pages10
JournalEuropean Journal of Heart Failure
Volume13
Issue number3
DOIs
Publication statusPublished - Mar 2011

Fingerprint

Ultrafiltration
Diuretics
Heart Failure
Hemodynamics
Brain Natriuretic Peptide
Aldosterone
Signs and Symptoms
Therapeutics
Cardiovascular System
Cardiac Output
Vascular Resistance
Stroke Volume
Pressure

Keywords

  • Diuretic therapy
  • Haemodynamic
  • Heart failure
  • Minimally invasive monitoring
  • Ultrafiltration

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effects of ULTRAfiltration vs. DIureticS on clinical, biohumoral and haemodynamic variables in patients with deCOmpensated heart failure : The ULTRADISCO study. / Giglioli, Cristina; Landi, Daniele; Cecchi, Emanuele; Chiostri, Marco; Gensini, Gian Franco; Valente, Serafina; Ciaccheri, Mauro; Castelli, Gabriele; Romano, Salvatore Mario.

In: European Journal of Heart Failure, Vol. 13, No. 3, 03.2011, p. 337-346.

Research output: Contribution to journalArticle

Giglioli, C, Landi, D, Cecchi, E, Chiostri, M, Gensini, GF, Valente, S, Ciaccheri, M, Castelli, G & Romano, SM 2011, 'Effects of ULTRAfiltration vs. DIureticS on clinical, biohumoral and haemodynamic variables in patients with deCOmpensated heart failure: The ULTRADISCO study', European Journal of Heart Failure, vol. 13, no. 3, pp. 337-346. https://doi.org/10.1093/eurjhf/hfq207
Giglioli, Cristina ; Landi, Daniele ; Cecchi, Emanuele ; Chiostri, Marco ; Gensini, Gian Franco ; Valente, Serafina ; Ciaccheri, Mauro ; Castelli, Gabriele ; Romano, Salvatore Mario. / Effects of ULTRAfiltration vs. DIureticS on clinical, biohumoral and haemodynamic variables in patients with deCOmpensated heart failure : The ULTRADISCO study. In: European Journal of Heart Failure. 2011 ; Vol. 13, No. 3. pp. 337-346.
@article{6b3ccac73b344bcfaffc6679937aa0af,
title = "Effects of ULTRAfiltration vs. DIureticS on clinical, biohumoral and haemodynamic variables in patients with deCOmpensated heart failure: The ULTRADISCO study",
abstract = "AimsTo evaluate the clinical, biohumoral, and haemodynamic effects of ultrafiltration vs. intravenous diuretics in patients with decompensated heart failure (HF). Signs and symptoms of volume overload are often present in these patients and standard therapy consists primarily of intravenous diuretics. Increasing evidence suggests that ultrafiltration can be an effective alternative treatment.Methods and resultsThirty patients with decompensated HF were randomly assigned to diuretics or ultrafiltration. Haemodynamic variables, including several novel parameters indicating the overall performance of the cardiovascular system, were continuously assessed with the Pressure Recording Analytical Method before, during, at the end of treatment (EoT) and 36 h after completing treatment. Aldosterone and N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma levels were also measured. Patients treated with ultrafiltration had a more pronounced reduction in signs and symptoms of HF at EoT compared with baseline, and a significant decrease in plasma aldosterone (0.24 ± 0.25 vs. 0.86 ± 1.04 nmol/L; P <0.001) and NT-proBNP levels (2823 ± 2474 vs. 5063 ± 3811 ng/L; P <0.001) compared with the diuretic group. The ultrafiltration group showed a significant improvement ( of baseline) in a number of haemodynamic parameters, including stroke volume index (114.0 ± 11.7; P <0.001), cardiac index (123.0 ± 20.8; P <0.001), cardiac power output (114.0 ± 13.8; P <0.001), dP/dtmax (129.5 ± 19.9; P <0.001), and cardiac cycle efficiency (0.24 ± 0.54 vs. -0.14 ± 0.50 units; P <0.05), and a significant reduction in systemic vascular resistance 36 h after the treatment (88.0 ± 10.9; P <0.001), which was not observed in the diuretic group.ConclusionsIn patients with advanced HF, ultrafiltration facilitates a greater clinical improvement compared with diuretic infusion by ameliorating haemodynamics (assessed using a minimally invasive methodology) without a marked increase in aldosterone or NT-proBNP levels.",
keywords = "Diuretic therapy, Haemodynamic, Heart failure, Minimally invasive monitoring, Ultrafiltration",
author = "Cristina Giglioli and Daniele Landi and Emanuele Cecchi and Marco Chiostri and Gensini, {Gian Franco} and Serafina Valente and Mauro Ciaccheri and Gabriele Castelli and Romano, {Salvatore Mario}",
year = "2011",
month = "3",
doi = "10.1093/eurjhf/hfq207",
language = "English",
volume = "13",
pages = "337--346",
journal = "European Journal of Heart Failure",
issn = "1388-9842",
publisher = "John Wiley & Sons, Ltd",
number = "3",

}

TY - JOUR

T1 - Effects of ULTRAfiltration vs. DIureticS on clinical, biohumoral and haemodynamic variables in patients with deCOmpensated heart failure

T2 - The ULTRADISCO study

AU - Giglioli, Cristina

AU - Landi, Daniele

AU - Cecchi, Emanuele

AU - Chiostri, Marco

AU - Gensini, Gian Franco

AU - Valente, Serafina

AU - Ciaccheri, Mauro

AU - Castelli, Gabriele

AU - Romano, Salvatore Mario

PY - 2011/3

Y1 - 2011/3

N2 - AimsTo evaluate the clinical, biohumoral, and haemodynamic effects of ultrafiltration vs. intravenous diuretics in patients with decompensated heart failure (HF). Signs and symptoms of volume overload are often present in these patients and standard therapy consists primarily of intravenous diuretics. Increasing evidence suggests that ultrafiltration can be an effective alternative treatment.Methods and resultsThirty patients with decompensated HF were randomly assigned to diuretics or ultrafiltration. Haemodynamic variables, including several novel parameters indicating the overall performance of the cardiovascular system, were continuously assessed with the Pressure Recording Analytical Method before, during, at the end of treatment (EoT) and 36 h after completing treatment. Aldosterone and N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma levels were also measured. Patients treated with ultrafiltration had a more pronounced reduction in signs and symptoms of HF at EoT compared with baseline, and a significant decrease in plasma aldosterone (0.24 ± 0.25 vs. 0.86 ± 1.04 nmol/L; P <0.001) and NT-proBNP levels (2823 ± 2474 vs. 5063 ± 3811 ng/L; P <0.001) compared with the diuretic group. The ultrafiltration group showed a significant improvement ( of baseline) in a number of haemodynamic parameters, including stroke volume index (114.0 ± 11.7; P <0.001), cardiac index (123.0 ± 20.8; P <0.001), cardiac power output (114.0 ± 13.8; P <0.001), dP/dtmax (129.5 ± 19.9; P <0.001), and cardiac cycle efficiency (0.24 ± 0.54 vs. -0.14 ± 0.50 units; P <0.05), and a significant reduction in systemic vascular resistance 36 h after the treatment (88.0 ± 10.9; P <0.001), which was not observed in the diuretic group.ConclusionsIn patients with advanced HF, ultrafiltration facilitates a greater clinical improvement compared with diuretic infusion by ameliorating haemodynamics (assessed using a minimally invasive methodology) without a marked increase in aldosterone or NT-proBNP levels.

AB - AimsTo evaluate the clinical, biohumoral, and haemodynamic effects of ultrafiltration vs. intravenous diuretics in patients with decompensated heart failure (HF). Signs and symptoms of volume overload are often present in these patients and standard therapy consists primarily of intravenous diuretics. Increasing evidence suggests that ultrafiltration can be an effective alternative treatment.Methods and resultsThirty patients with decompensated HF were randomly assigned to diuretics or ultrafiltration. Haemodynamic variables, including several novel parameters indicating the overall performance of the cardiovascular system, were continuously assessed with the Pressure Recording Analytical Method before, during, at the end of treatment (EoT) and 36 h after completing treatment. Aldosterone and N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma levels were also measured. Patients treated with ultrafiltration had a more pronounced reduction in signs and symptoms of HF at EoT compared with baseline, and a significant decrease in plasma aldosterone (0.24 ± 0.25 vs. 0.86 ± 1.04 nmol/L; P <0.001) and NT-proBNP levels (2823 ± 2474 vs. 5063 ± 3811 ng/L; P <0.001) compared with the diuretic group. The ultrafiltration group showed a significant improvement ( of baseline) in a number of haemodynamic parameters, including stroke volume index (114.0 ± 11.7; P <0.001), cardiac index (123.0 ± 20.8; P <0.001), cardiac power output (114.0 ± 13.8; P <0.001), dP/dtmax (129.5 ± 19.9; P <0.001), and cardiac cycle efficiency (0.24 ± 0.54 vs. -0.14 ± 0.50 units; P <0.05), and a significant reduction in systemic vascular resistance 36 h after the treatment (88.0 ± 10.9; P <0.001), which was not observed in the diuretic group.ConclusionsIn patients with advanced HF, ultrafiltration facilitates a greater clinical improvement compared with diuretic infusion by ameliorating haemodynamics (assessed using a minimally invasive methodology) without a marked increase in aldosterone or NT-proBNP levels.

KW - Diuretic therapy

KW - Haemodynamic

KW - Heart failure

KW - Minimally invasive monitoring

KW - Ultrafiltration

UR - http://www.scopus.com/inward/record.url?scp=79951829308&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79951829308&partnerID=8YFLogxK

U2 - 10.1093/eurjhf/hfq207

DO - 10.1093/eurjhf/hfq207

M3 - Article

C2 - 21131387

AN - SCOPUS:79951829308

VL - 13

SP - 337

EP - 346

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

IS - 3

ER -