Heart failure & cardiomyopathiesCohort study
Observational Study for Multiparametric Assessment of Cardiac Congestion in Outpatient Worsening Heart Failure (EVOLUTION)
- Prospective observational cohort study
Authors' conclusion
Patients with high levels of troponin, or NT-proBNP, or cystatin C who develop WHF despite being treated with a loop diuretic, need novel therapies for WHF.
Study context
- Population
- Outpatients with EF <50% and worsening HF symptoms in the preceding week, treated in an outpatient setting39 assessed at week 4
- Participants
- 44 outpatients
Main finding
As reported in the abstract
Response to fluid challenge (1 L Ringer over 2 h) at week 4 · week 4
Urine volume over 3 h, median (IQR)
300 (200.0-500.0) ml
Urine sodium excreted over 3 h, median (IQR)
39.6 (12.4-63.0) mEq
Predictors of non-response to fluid challenge (ROC): cystatin C, NT-proBNP, high-sensitivity troponin T; all three markers associated with the worst response
cystatin C >1.2 ng/ml, NT-proBNP >1500 pg/ml, hs troponin T >20 pg/ml
Observational data: associations, not effects.
Further findings
Symptoms and quality of life · 4 weeks
- Patient-reported and physician-assessed symptoms and quality of life improved over the 4 weeks
Original publication
Observational Study for Multiparametric Assessment of Cardiac Congestion in Outpatient Worsening Heart Failure (EVOLUTION). Eur J Heart Fail. Published 18 December 2024. doi:10.1002/ejhf.3555
Summarised from the published abstract; every number is checked against it