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Abstract
Hospital readmission rates in chronic heart failure are high. Natriuretic peptides, ultrasound lung comets, and tissue doppler assessment of left ventricular end diastolic pressure are tools that can diagnose subclinical pulmonary congestion. There is controversy about the role of these tools in reducing heart failure hospitalization rate. Compare re-hospitalization rates with treatment guided by clinical findings alone vs. added guidance by natriuretic peptide, ultrasound lung comets therapy or tissue doppler imaging. from August 2012 till December 2014, we randomized 100 hospitalized patients with heart failure and reduced ejection fraction to 4 equal groups. group 1: treatment was guided by clinical findings alone. group 2: treatment was guided by clinical findings and brain natriuretic peptide point of care (targeting level < 200 pg / ml). group 3: treatment was guided by clinical findings and ultrasound lung comets targeting a score below 15. group 4: treatment was guided by clinical findings and Doppler imaging to measure E/Ea targeting a mean below 10. We excluded patients with acute or chronic renal failure, chronic lung disease, massive pericardial effusion, and acute coronary syndrome. We followed the patients up to 6 months to assess re - hospitalization rate