Assuntos
Terapia de Ressincronização Cardíaca/métodos , Cardiomiopatia Dilatada , Fármacos Cardiovasculares/uso terapêutico , Insuficiência Cardíaca , Cardiomiopatia Dilatada/complicações , Cardiomiopatia Dilatada/diagnóstico , Progressão da Doença , Ecocardiografia/métodos , Eletrocardiografia/métodos , Feminino , Gadolínio , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/terapia , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
UNLABELLED: Slow continuous ultrafiltration (SCUF), continuous veno venous haemofiltration (CVVHF) are alternative to diuretics methods of treatment of patients with chronic heart failure (CHF), edematous syndrome. METHODS: Patients of both sexes aged 30-82 years with functional class II-IV CHF were included because of decompensation of CHF. Randomization: experiment - 19 patients, 3-4 component therapy plus SCUF or CVVHF; control - 3-4 component therapy plus intravenous furosemide. EXAMINATION: I ñ at baseline, II ñ after compensation of CHF. RESULTS: Delta weight (kg) - experiment -10.1+/-1.08, control -1.92+/-0.83, p=0.00001; Delta left ventricular ejection fraction - experiment +10.09+/-2.26, control +0.52+/-1.14, p=0.0007; pulmonary artery systolic pressure (mm Hg) - experiment -12.32+/-3,43, control -4.05 +/-2.07, p=0.029; Delta 6 min walk test: experiment +304.22+/-39.4, control +91.91+/-23.4, p=0.00003; Delta glomerular filtration rate - experiment -1.16+/-3.23, control +4.44+/-3.68, p=0.85; duration of hospitalization (days) - experiment 17.26+/-1.43, control 17.52+/-1.02, p=0.59. We did not observe complications related to renal replacement therapy. CONCLUSION: SCUF and CVVHF are safe for patients. In decompensated CHF SCUF and CVVHF provide greater weight reduction and fluid removal than intravenous diuretics, abolish hypervolemia what cause improvement of myocardial contractility.
