Cardiac Indices Parameters on the Ultrasonic Cardiac Output Monitor as Potential Indicators to Predict the Ultrafiltration Endpoint Success in Acute Heart Failure Treatment.

Background: Ultrafiltration (UF) is an alternative approach to diuretic therapy for the treatment of acute heart failure (AHF), but its optimal endpoint is unclear. This study explores using non-invasive ultrasonic cardiac output monitor (USCOM) to determine UF endpoints based on hemodynamic changes. Methods: In this single-anonymized, randomized controlled trial, acute decompensated heart failure patients were randomly assigned to UF (U, n = 20) and USCOM+UF (UU, n = 20) groups at a ratio of 1:1. A mixed linear model was utilized to analyze repeated measurement data of hemodynamic indicators (primary endpoint) in the U and UU groups. A 30% or 50% decrease in B-type natriuretic peptide (BNP) concentrations relative to the baseline was established as the criteria for the UF endpoint success. Multivariate logistic regression was used to identify potential indicators within the USCOM that could have influenced the UF endpoint success. Receiver operating characteristic (ROC) curves were used to evaluate the value of the predictive model. Economic benefits, including treatment costs and hospitalization duration, were also assessed. Results: Change rates in mean arterial pressure, heart rate (HR), urine output, hematocrit, and BNP concentrations were similar between the U and UU groups over 7 days (all Conclusions: Observing the USCOM using probability formulas served to determine appropriate UF endpoints during AHF treatments. UF combined with the USCOM can reduce the costs of UF and hospitalization. Clinical Trial Registration: NCT06533124, https://clinicaltrials.gov/study/NCT06533124?term=NCT06533124&rank=1.