Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações

Vecchis, Renato De; Ciccarelli, Antonio; Ariano, Carmelina

doi:10.1590/s0066-782x2012005000049

Cited by 5 publications

(2 citation statements)

References 30 publications

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“…Among the signs deduced from physical examination, we used jugular venous distention (JVD) and orthopnea for assessing and grading volume status, according to other authors [7,8]. In addition, we used two other objective variables, recognized to be suitable to evaluate decongestion [9,10,11]: weight loss and reduction in the inferior vena cava (IVC) maximum (i.e., expiratory) diameter from admission to discharge. Furthermore, we entered the above-mentioned variables into the multivariate Cox proportional-hazards regression models used for identifying the predictors of six-month all-cause mortality (see Section 3.1).…”

Section: Methodsmentioning

confidence: 99%

RETRACTED: An Admission-to-Discharge BNP Increase Is a Predictor of Six-Month All-Cause Death in ADHF Patients: Inferences from Multivariate Analysis Including Admission BNP and Various Clinical Measures of Congestion

Vecchis

Ariano

Baldi

2016

JCM

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Background: According to some authors, a single isolated measurement of serum B-type natriuretic peptide (BNP) executed on hospital admission would not be a sufficiently accurate method to predict the outcome of patients with acute decompensated heart failure (ADHF). Aims: To verify this assumption, a retrospective study was conducted on patients hospitalized for ADHF. Our main objective was to ascertain whether there was any difference in midterm mortality among patients with increasing BNP at discharge as compared with those with decreasing BNP at discharge. Methods: Medical records were examined so as to make a partition of the ADHF patient population into two groups, the former characterized by a rise in BNP during hospitalization, and the latter exhibiting a decrease in BNP in the measurement taken at hospital discharge. Results: 177 patients were enrolled in a retrospective study. Among them, 53 patients (30%) had increased BNP at the time of discharge, whereas 124 (70%) showed decreases in serum BNP during their hospital stay. The group with patients who exhibited BNP increases at the time of discharge had a higher degree of congestion evident in the higher frequency of persistent jugular venous distention and persistent orthopnea at discharge. Moreover, patients with increased BNP at the time of discharge had a lower reduction in inferior vena cava maximum diameter (1.58 ± 2.2 mm vs. 6.32 ± 1.82 mm; p (one-way ANOVA) = 0.001). In contrast, there was no significant difference in weight loss when patients with increased BNP at discharge were compared with those with no such increase. A total of 14 patients (7.9%) died during the six-month follow-up period. Multivariable Cox proportional-hazards regression analysis revealed that a BNP increase at the time of discharge was an independent predictor of six-month all-cause mortality after adjustment for persistent jugular venous distention, persistent orthopnea, reduction in inferior vena cava maximum diameter at discharge, weight loss, serum urea, systolic blood pressure at admission, and BNP at admission (hazard ratio = 30.5424; 95% CI: 1.7409–535.8294, p = 0.0199). Conclusions: Among patients with a history of ADHF, more elevated BNP levels at the time of discharge from the hospital compared with those detected at admission identify a patient subset with a higher grade of congestion and higher six-month mortality.

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Section: Methodsmentioning

confidence: 99%

RETRACTED: An Admission-to-Discharge BNP Increase Is a Predictor of Six-Month All-Cause Death in ADHF Patients: Inferences from Multivariate Analysis Including Admission BNP and Various Clinical Measures of Congestion

Vecchis

Ariano

Baldi

2016

JCM

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“…A distensão da veia jugular, identificada em 37,6% dos pacientes, é uma medida que indica as alterações do volume das câmaras cardíacas direita, além de ser um marcador de retenção hidrossalina, normalmente encontrado na congestão sistêmica decorrente de insuficiência cardíaca direita ou bi-ventricular avançada 25 . Nessa perspectiva, sabe-se da incidência elevada da insuficiência cardíaca nos pacientes com insuficiência renal crônica, o que justifica a identificação de tal manifestação 26 .…”

Section: Manifestações Cardiovasculares E Pulmonaresunclassified

Alterações cardiovasculares e pulmonares em pacientes submetidos à hemodiálise [Cardiovascular and pulmonary changes in patients undergoing hemodialysis] [Alteraciones cardiovasculares y pulmonares en pacientes sometidos a hemodiálisis]

et al. 2016

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RESUMO Objetivo: identificar alterações cardiovasculares e pulmonares em pacientes em hemodiálise, correlacionando-as aos aspectos socioeconômicos. Método: estudo transversal, realizado em um hospital universitário e em uma clínica de hemodiálise do Nordeste do Brasil, entre os meses de dezembro de 2012 a abril de 2013. A coleta de dados deu-se por meio da entrevista e exame físico. Para análise utilizou-se a estatística descritiva e inferencial por meio dos testes de Qui-quadrado e U de Mann-Whitney. Houve aprovação pelo Comitê de Ética em Pesquisa, com parecer nº 148.428. Resultados: as alterações cardiovasculares mais frequentes foram: edema, mudança na pressão arterial, pressão venosa central e refluxo hepatojugular positivo. As alterações pulmonares foram: congestão pulmonar e ruídos respiratórios adventícios. As variáveis dispneia e mudança do padrão respiratório apresentaram associação estatisticamente significativa com renda familiar. Conclusão: as alterações cardiovasculares e pulmonares são frequentes na clientela pesquisada e esses problemas podem sofrer influências de dados socioeconômicos. Palavras-chave: Enfermagem; insuficiência renal crônica; sistema cardiovascular; sistema respiratório.

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Role of Point‐of‐Care Lung and Inferior Vena Cava Ultrasound in Clinical Decisions for Patients Presenting to the Emergency Department With Symptoms of Acute Decompensated Heart Failure

Hacıalioğulları

Yılmaz²,

Yılmaz

et al. 2020

J of Ultrasound Medicine

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Objectives This prospective study was performed to evaluate the diagnostic role of point‐of‐care lung ultrasound (LUS) and inferior vena cava (IVC) ultrasound in patients with acute decompensated heart failure (ADHF). Methods A prospective cohort study was conducted between January 2018 and November 2018 on patients with a diagnosis of ADHF in the emergency department (ED). On admission, LUS findings, inspiratory and expiratory IVC diameters, and the inferior vena cava collapsibility index (IVCCI) were obtained. After therapeutic interventions, third‐hour changes in LUS and the IVC index and the treatment response were assessed. Results Eighty patients were enrolled. Forty‐six (58%) patients had an ejection fraction (EF) greater than 40%, and 34 (42%) had an EF of less than 40%. Significant differences were detected between the admission and third‐hour inspiratory IVC diameter, expiratory IVC diameter, and IVCCI (P = .001). There was no correlation between the EF and inspiratory IVC diameter (r = −0.03; P = .976), expiratory IVC diameter (r = −109; P = .336), or IVCCI (r = −0.72; P = .523) and between the B‐type natriuretic peptide level and inspiratory IVC diameter (r = −0.58; P = .610), expiratory IVC diameter (r = −0.33; P = .774), or IVCCI (r = −0.78; P = .493) either. A comparison of admission and third‐hour numbers of B‐lines on LUS imaging showed a significant decrease in the number of B‐lines in all zones at the end of 3 hours (P = .001). A significant difference existed between the hospitalized and discharged patients with respect to IVC diameters and number of B‐lines. Conclusions In the ED setting, an assessment of B‐lines and measurement of IVC diameters are better markers than the B‐type natriuretic peptide level, EF, or chest x‐ray for diagnosis of ADHF and can be used to make decisions for hospitalization or discharge from the ED.

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Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações

Abstract: Background: In chronic heart failure patients (CHF), ultrasound measurement of inferior vena cava collapsibility index (IVCCI) has been proposed to yield careful assessment and grading of the hemodynamic congestion.

Cited by 5 publications

References 30 publications

RETRACTED: An Admission-to-Discharge BNP Increase Is a Predictor of Six-Month All-Cause Death in ADHF Patients: Inferences from Multivariate Analysis Including Admission BNP and Various Clinical Measures of Congestion

RETRACTED: An Admission-to-Discharge BNP Increase Is a Predictor of Six-Month All-Cause Death in ADHF Patients: Inferences from Multivariate Analysis Including Admission BNP and Various Clinical Measures of Congestion

Alterações cardiovasculares e pulmonares em pacientes submetidos à hemodiálise [Cardiovascular and pulmonary changes in patients undergoing hemodialysis] [Alteraciones cardiovasculares y pulmonares en pacientes sometidos a hemodiálisis]

Role of Point‐of‐Care Lung and Inferior Vena Cava Ultrasound in Clinical Decisions for Patients Presenting to the Emergency Department With Symptoms of Acute Decompensated Heart Failure

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