Terapia da insuficiência cardíaca avançada ajustada por objetivos hemodinâmicos obtidos pela monitorização invasiva

Júnior, Gustavo Luiz Gouvêa de Almeida; Esporcatte, Roberto; Rangel, Fod; Rocha, Ricardo Mourilhe; Silva, Gustavo de Miranda Gouvêa e; Tura, Bernardo Rangel; Jorge, José Kezen Camilo; Drumond, L; Filho, Francisco Manes Albanesi

doi:10.1590/s0066-782x2005001700004

Arq. Bras. Cardiol.

2005

DOI: 10.1590/s0066-782x2005001700004

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Terapia da insuficiência cardíaca avançada ajustada por objetivos hemodinâmicos obtidos pela monitorização invasiva

Gustavo Luiz Gouvêa de Almeida Júnior¹,

Roberto Esporcatte²,

Fod Rangel³

et al.

Abstract: It was possible to reduce ventricular filling pressures to significantly lower values, obtaining a significant improvement of cardiac index, systemic vascular resistance index and pulmonary artery mean pressure, by using significantly higher doses of vasodilators.

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Natriuretic Peptide and Clinical Evaluation in the Diagnosis of Heart Failure Hemodynamic Profile: Comparison with Tissue Doppler Echocardiography

Almeida¹,

Clausell²,

Garcia³

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundPhysical examination and B-type natriuretic peptide (BNP) have been used to estimate hemodynamics and tailor therapy of acute decompensated heart failure (ADHF) patients. However, correlation between these parameters and left ventricular filling pressures is controversial.ObjectiveThis study was designed to evaluate the diagnostic accuracy of physical examination, chest radiography (CR) and BNP in estimating left atrial pressure (LAP) as assessed by tissue Doppler echocardiogram.MethodsPatients admitted with ADHF were prospectively assessed. Diagnostic characteristics of physical signs of heart failure, CR and BNP in predicting elevation (> 15 mm Hg) of LAP, alone or combined, were calculated. Spearman test was used to analyze the correlation between non-normal distribution variables. The level of significance was 5%.ResultsForty-three patients were included, with mean age of 69.9 ± 11.1years, left ventricular ejection fraction of 25 ± 8.0%, and BNP of 1057 ± 1024.21 pg/mL. Individually, all clinical, CR or BNP parameters had a poor performance in predicting LAP ≥ 15 mm Hg. A clinical score of congestion had the poorest performance [area under the receiver operating characteristic curve (AUC) 0.53], followed by clinical score + CR (AUC 0.60), clinical score + CR + BNP > 400 pg/mL (AUC 0.62), and clinical score + CR + BNP > 1000 pg/mL (AUC 0.66).ConclusionPhysical examination, CR and BNP had a poor performance in predicting a LAP ≥ 15 mm Hg. Using these parameters alone or in combination may lead to inaccurate estimation of hemodynamics.

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Natriuretic Peptide and Clinical Evaluation in the Diagnosis of Heart Failure Hemodynamic Profile: Comparison with Tissue Doppler Echocardiography

Almeida¹,

Clausell²,

Garcia³

et al. 2018

Arquivos Brasileiros De Cardiologia

Self Cite

View full text Add to dashboard Cite

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Terapia da insuficiência cardíaca avançada ajustada por objetivos hemodinâmicos obtidos pela monitorização invasiva

Abstract: It was possible to reduce ventricular filling pressures to significantly lower values, obtaining a significant improvement of cardiac index, systemic vascular resistance index and pulmonary artery mean pressure, by using significantly higher doses of vasodilators.

Cited by 1 publication

References 21 publications

Natriuretic Peptide and Clinical Evaluation in the Diagnosis of Heart Failure Hemodynamic Profile: Comparison with Tissue Doppler Echocardiography

Natriuretic Peptide and Clinical Evaluation in the Diagnosis of Heart Failure Hemodynamic Profile: Comparison with Tissue Doppler Echocardiography

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