Assessment of early treatment response by rapid cardiothoracic ultrasound in acute heart failure : Cardiac filling pressures, pulmonary congestion and mortality

Show full item record



Permalink

http://hdl.handle.net/10138/304107

Citation

Öhman , J , Harjola , V-P , Karjalainen , P & Lassus , J 2018 , ' Assessment of early treatment response by rapid cardiothoracic ultrasound in acute heart failure : Cardiac filling pressures, pulmonary congestion and mortality ' , European Heart Journal: Acute Cardiovascular Care , vol. 7 , no. 4 , pp. 311-320 . https://doi.org/10.1177/2048872617708974

Title: Assessment of early treatment response by rapid cardiothoracic ultrasound in acute heart failure : Cardiac filling pressures, pulmonary congestion and mortality
Author: Öhman, Jonas; Harjola, Veli-Pekka; Karjalainen, Pasi; Lassus, Johan
Contributor: University of Helsinki, HUS Emergency Medicine and Services
University of Helsinki, HUS Heart and Lung Center
Date: 2018-06
Language: eng
Number of pages: 10
Belongs to series: European Heart Journal: Acute Cardiovascular Care
ISSN: 2048-8726
URI: http://hdl.handle.net/10138/304107
Abstract: Background: It is unclear how to optimally monitor acute heart failure (AHF) patients. We evaluated the timely interplay of cardiac filling pressures, brain natriuretic peptides (BNPs), lung ultrasound (LUS) and symptoms during AHF treatment. Methods: We enrolled 60 patients who had been hospitalised for AHF. Patients were examined with a rapid cardiothoracic ultrasound (CaTUS) protocol, combining LUS and focused echocardiographic evaluation of cardiac filling pressures (i.e. medial E/e' and inferior vena cava index [IVCi]). CaTUS was done at 0, 12, 24 and 48 hours (3 hours) and on the day of discharge, alongside clinical evaluation and laboratory samples. Patients free of congestion (Blines or pleural fluid) on LUS at discharge were categorised as responders, whereas the rest were categorised as non-responders. Improvement in congestion parameters was evaluated separately in these groups. The effect of congestion parameters on prognosis was also analysed. Results: Responders experienced a significantly larger decline in E/e' (2.58 vs. 0.38, p=0.037) and dyspnoea visual analogue scale (1-10) score (7.68 vs. 3.57, p=0.007) during the first 12 hours of treatment, while IVCi and BNPs declined later without no such rapid initial decline. Among patients experiencing a >3 U decline in E/e' during the first 12 hours of treatment, 18/21 were to become responders (p Conclusion: E/e' seemed like the most useful congestion parameter for monitoring early treatment response, predicting prognostically beneficial resolution of pulmonary congestion.
Subject: ADHERE
ASSOCIATION
ECHOCARDIOGRAPHY
Echocardiography
GUIDELINES
HEMODYNAMIC DETERMINANTS
LUNG ULTRASOUND
MANAGEMENT
MULTICENTER
NATRIURETIC PEPTIDE
PROGNOSTIC VALUE
acute heart failure
haemodynamics
lung ultrasound
prognosis
pulmonary congestion
3126 Surgery, anesthesiology, intensive care, radiology
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
2048872617708974.pdf 503.8Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record