000170106 001__ 170106
000170106 005__ 20260318155254.0
000170106 0247_ $$2doi$$a10.1016/j.rceng.2025.502332
000170106 0248_ $$2sideral$$a148611
000170106 037__ $$aART-2025-148611
000170106 041__ $$aeng
000170106 100__ $$aCampos Sáenz de Santamaría, A.$$uUniversidad de Zaragoza
000170106 245__ $$aMultimodal analysis of congestion and prognostic utility of the VExUS protocol in hospitalized heart failure patients at a tertiary care hospital
000170106 260__ $$c2025
000170106 5060_ $$aAccess copy available to the general public$$fUnrestricted
000170106 5203_ $$aBackground
Multimodal assessment of congestion and venous excess ultrasound protocol (VExUS) play a determinant role for volume assessment and decongestive therapy in patients with acute heart failure (AHF).
Methods
Prospective, unicentrical and observational study in patients admitted for AHF at the Internal Medicine ward, designed to explore the prevalence, predictors and clinical outcomes of congestion (VExUS score) and the prevalence of congestive nephropathy.
Results
A total of 100 patients were included (mean age 86 ± 8 years were and 51% females). According to VExUS protocol, 49% exhibited moderate to severe congestion (VExUS 2-3). These patients were more clinical congested, showed higher concentrations of CA125 and microalbumin/creatinine ratio, and need greater doses of loop diuretics during hospitalization. The prevalence of congestive nephropathy on admission was 38%. Patients with VExUS score on admission ≥ 2 had a 2.5-fold increased risk for all-cause mortality and/or HF hospitalization at 1 year (OR 2.52, 95% CI 1.02–6.26, p = 0.046). In multivariable analysis elevated urea levels, larger inferior vena cava diameter and male gender, were identified as independent predictors on top of VExUS score for one-year mortality with an area under the curve for the final model of 0.740 (p < 0.001).
Conclusions
Moderate to severe congestion (VExUS grade 2-3) is associated with higher clinical congestion scores, greater need for diuretic treatment, and worse clinical outcomes, including increased mortality and rehospitalization rates in AHF. Furthermore, one-third of AHF showed congestion nephropathy a situation with clinical relevance that can influence decongestive treatments and final outcomes.
000170106 536__ $$9info:eu-repo/grantAgreement/ES/DGA/B07-23R$$9info:eu-repo/grantAgreement/ES/DGA/T71-23D$$9info:eu-repo/grantAgreement/ES/MCIU/PID2022-139143OA-I00
000170106 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000170106 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000170106 700__ $$0(orcid)0000-0002-0166-2837$$aAlcaine Otín, A.$$uUniversidad de Zaragoza
000170106 700__ $$aCrespo Aznarez, S.
000170106 700__ $$0(orcid)0000-0002-8328-9836$$aJosa Laorden, C.
000170106 700__ $$aEsterellas Sánchez, L.
000170106 700__ $$0(orcid)0000-0002-2338-7637$$aSánchez Marteles, M.$$uUniversidad de Zaragoza
000170106 700__ $$aGarcés Horna, V.$$uUniversidad de Zaragoza
000170106 700__ $$aAlbines Fiestas, Z.$$uUniversidad de Zaragoza
000170106 700__ $$aGiménez López, I.
000170106 700__ $$0(orcid)0000-0002-4769-7154$$aRubio Gracia, J.$$uUniversidad de Zaragoza
000170106 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000170106 7102_ $$15007$$2570$$aUniversidad de Zaragoza$$bDpto. Informát.Ingenie.Sistms.$$cÁrea Lenguajes y Sistemas Inf.
000170106 773__ $$g225, 7 (2025), 502332 [12 pp.]$$tRevista Clínica Española (English Edition)$$x2254-8874
000170106 8564_ $$s1216501$$uhttps://zaguan.unizar.es/record/170106/files/texto_completo.pdf$$yVersión publicada
000170106 8564_ $$s2101433$$uhttps://zaguan.unizar.es/record/170106/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000170106 909CO $$ooai:zaguan.unizar.es:170106$$particulos$$pdriver
000170106 951__ $$a2026-03-18-13:52:24
000170106 980__ $$aARTICLE