Non-Invasive Assessment of Congestion by Cardiovascular and Pulmonary Ultrasound and Biomarkers in Heart Failure

Ilieșiu, Adriana; Hodorogea, Andreea Simona; Balahura, Ana Maria; Bădilă, Elisabeta

doi:10.3390/diagnostics12040962

Cited by 6 publications

(3 citation statements)

References 155 publications

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“…However, the decrease in IVC diameter and the increase in IVC collapsibility index were both correlated with the improvement of eGFR decline rate after treatment with SGLT2 inhibitors. Better fluid control during outpatient visits following the introduction of SGLT2 inhibitors was linked to central venous pressure decrease, which acted in a renal protective manner via improvement of renal congestion and may have induced the favorable effect on renal function in this study, although it is only our speculation because we did not directly assess renal congestion by examining intrarenal venous flow patterns or otherwise [42] .…”

Section: Discussionmentioning

confidence: 90%

Renoprotective effect of chronic treatment with sodium-glucose cotransporter 2 inhibitors and its associated factors in Japanese patients with chronic heart failure and diabetes

Yokouchi¹,

Horio²,

Matsumoto³

et al. 2022

IJC Heart & Vasculature

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Section: Discussionmentioning

confidence: 90%

Renoprotective effect of chronic treatment with sodium-glucose cotransporter 2 inhibitors and its associated factors in Japanese patients with chronic heart failure and diabetes

Yokouchi¹,

Horio²,

Matsumoto³

et al. 2022

IJC Heart & Vasculature

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“…➢ RA volume (Single plane): Tracing the RA inner boundary omitting the area under the TV annulus from an apical 4 chamber view that contains the whole RA and was not foreshortened (dedicated right heart view) (8) . ➢ Systolic PAP (sPAP): by assessment of TR velocity & IVC size & collapsibility (9) .…”

Section: Methodsmentioning

confidence: 99%

Assessment of Right ventricular Systolic and Diastolic Function in Rheumatic Heart Disease in Suez Canal University Hospital

2023

The Egyptian Journal of Hospital Medicine

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Background: Right ventricular (RV) dysfunction, despite its importance as a prognostic factor, has been underestimated in patients with rheumatic valvular disease. Early detection of RV functional changes may improve the outcome of patients particularly if detected in early stages of rheumatic heart disease (RHD) (mild to moderate). Objective: To assess RV function in patients with early stages of RHD and in order to observe changes in RV function, we repeated the measurements (follow up) at 6 months form baseline. Patients and methods: 50 consecutive patients with mild to moderate valvular RHD were enrolled in this study in which we assessed the RV systolic and diastolic functions, LA and RA volume and sPAP. Results: In RHD patients with mild to moderate valvular lesion RV systolic function was normal by using different methods (TAPSE, RIMP, FAC and S' wave). TAPSE was normal at baseline & follow up with increase at follow up but with statistical insignificant difference. 2D FAC is normal at baseline & follow up with decrease at follow up but with statistically insignificant difference. RIMP showed impaired RV systolic function at baseline with mean of 0.73 ± 0.26 & at follow up with mean of 0.56 ± 0.14 with statistically significant decrease at follow up. S' wave showed normal RV systolic function at baseline (mean 14.32 ± 2.36) & follow up (mean 13.09 ± 1.48) with statistical significant decrease at follow up. Conclusion:There is association between RV functions and degree of valve disease in patients with RHD.

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“…Objective assessment of hemodynamic conditions is fundamental to guide the clinical management of the cardiac surgery patient during the postoperative period [ 1 , 2 , 3 ]. Meticulous fluid management is crucial in patients undergoing cardiac surgery, particularly in those with heart failure; prolonged operative and aortic cross-clamp time; or preexisting kidney, lung, or liver dysfunction [ 4 , 5 ]. Recent studies suggested that abdominal congestion can lead to or worsen renal and hepatic dysfunction and thus increase the risk of postoperative complications and lead to higher resource utilization [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Association between Hepatic Venous Congestion and Adverse Outcomes after Cardiac Surgery

et al. 2022

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Introduction: Hepatic venous flow patterns reflect pressure changes in the right ventricle and are also markers of systemic venous congestion. Fluid management is crucial in patients undergoing cardiac surgery. Methods: Our goal was to determine which factors are associated with the increased congestion of the liver as measured by Doppler ultrasound in patients undergoing cardiac surgery. This prospective, observational study included 41 patients without preexisting liver disease who underwent cardiac surgery between 1 January 2021 and 30 September 2021 at a tertiary heart center. In addition to routine echocardiographic examination, we recorded the maximal velocity and velocity time integral (VTI) of the standard four waves seen in the common hepatic vein (flow profile) using Doppler ultrasound preoperatively and at the 20–24th hour of the postoperative period. The ratios of the retrograde and anterograde hepatic venous waves were calculated, and the waveforms were compared to the baseline value and expressed as a delta ratio. Demographic data, pre- and postoperative echocardiographic parameters, intraoperative variables (procedure, cardiopulmonary bypass time), postoperative factors (fluid balance, vasoactive medication requirement, ventilation time and parameters) and perioperative laboratory parameters (liver and kidney function tests, albumin) were used in the analysis. Results: Of the 41 patients, 20 (48.7%) were males, and the median age of the patients was 65.9 years (IQR: 59.8–69.9 years). Retrograde VTI growth showed a correlation with positive fluid balance (0.89 (95% CI 0.785–0.995) c-index. After comparing the postoperative echocardiographic parameters of the two subgroups, right ventricular and atrial diameters were significantly greater in the “retrograde VTI growth” group. The ejection fraction and decrement in ejection fraction to preoperative parameters were significantly different between the two groups. (p = 0.001 and 0.003). Ventilation times were longer in the retrograde VTI group. The postoperative vs. baseline delta VTI ratio of the hepatic vein correlated with positive fluid balance, maximum central venous pressure, and ejection fraction. (B = −0.099, 95% CI = −0.022–0.002, p = 0.022, B = 0.011, 95% CI = 0.001–0.021, p = 0.022, B = 0.091, 95% CI = 0.052–0.213, p = 0.002, respectively.) Conclusion: The increase of the retrograde hepatic flow during the first 24 h following cardiac surgery was associated with positive fluid balance and the decrease of the right ventricular function. Measurement of venous congestion or venous abdominal insufficiency seems to be a useful tool in guiding fluid therapy and hemodynamic management.

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Non-Invasive Assessment of Congestion by Cardiovascular and Pulmonary Ultrasound and Biomarkers in Heart Failure

Cited by 6 publications

References 155 publications

Renoprotective effect of chronic treatment with sodium-glucose cotransporter 2 inhibitors and its associated factors in Japanese patients with chronic heart failure and diabetes

Renoprotective effect of chronic treatment with sodium-glucose cotransporter 2 inhibitors and its associated factors in Japanese patients with chronic heart failure and diabetes

Assessment of Right ventricular Systolic and Diastolic Function in Rheumatic Heart Disease in Suez Canal University Hospital

Association between Hepatic Venous Congestion and Adverse Outcomes after Cardiac Surgery

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