Implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure
Arq. bras. cardiol
;
78(3): 261-266, Mar. 2002. tab, graf
Article
in English
| LILACS
| ID: lil-305032
ABSTRACT
OBJECTIVE:
To report the hemodynamic and functional responses obtained with clinical optimization guided by hemodynamic parameters in patients with severe and refractory heart failure.METHODS:
Invasive hemodynamic monitoring using right heart catheterization aimed to reach low filling pressures and peripheral resistance. Frequent adjustments of intravenous diuretics and vasodilators were performed according to the hemodynamic measurements.RESULTS:
We assessed 19 patients (age = 48±12 years and ejection fraction = 21±5 percent) with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43 percent) pulmonary artery occlusion pressure (P<0.001), with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24 percent, P<0.001). We observed significant associations between pulmonary artery occlusion pressure and mean pulmonary artery pressure (r=0.76; P<0.001) and central venous pressure (r=0.63; P<0.001). After clinical optimization, improvement in functional class occurred (P< 0.001), with a tendency towards improvement in ejection fraction and no impairment to renal function.CONCLUSION:
Optimization guided by hemodynamic parameters in patients with refractory heart failure provides a significant improvement in the hemodynamic profile with concomitant improvement in functional class. This study emphasizes that adjustments in blood volume result in imme-diate benefits for patients with severe heart failure
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Cardiac Catheterization
/
Cardiac Output, Low
/
Hemodynamics
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Arq. bras. cardiol
Journal subject:
Cardiology
Year:
2002
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade Federal do Rio Grande do Sul/BR
Similar
MEDLINE
...
LILACS
LIS