Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure
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...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Cardiologia (SBC)
2002-03-01
|
| Series: | Arquivos Brasileiros de Cardiologia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2002000300001 |
| _version_ | 1818198436132945920 |
|---|---|
| author | Luís E. Rohde Thiago Furian Candice Campos Andreia Biolo Eneida Rabelo Murilo Foppa Nadine Clausell |
| author_facet | Luís E. Rohde Thiago Furian Candice Campos Andreia Biolo Eneida Rabelo Murilo Foppa Nadine Clausell |
| author_sort | Luís E. Rohde |
| collection | DOAJ |
| description | 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%) with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43%) pulmonary artery occlusion pressure (P<0.001), with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, 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. |
| first_indexed | 2024-12-12T02:05:50Z |
| format | Article |
| id | doaj.art-12ab6d0aa4cc431fa1e55d471eee8025 |
| institution | Directory Open Access Journal |
| issn | 0066-782X 1678-4170 |
| language | English |
| last_indexed | 2024-12-12T02:05:50Z |
| publishDate | 2002-03-01 |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-12ab6d0aa4cc431fa1e55d471eee80252022-12-22T00:42:03ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia0066-782X1678-41702002-03-0178326126610.1590/S0066-782X2002000300001Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart FailureLuís E. RohdeThiago FurianCandice CamposAndreia BioloEneida RabeloMurilo FoppaNadine ClausellOBJECTIVE: 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%) with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43%) pulmonary artery occlusion pressure (P<0.001), with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2002000300001heart failuretreatmenthemodynamic optimization |
| spellingShingle | Luís E. Rohde Thiago Furian Candice Campos Andreia Biolo Eneida Rabelo Murilo Foppa Nadine Clausell Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure Arquivos Brasileiros de Cardiologia heart failure treatment hemodynamic optimization |
| title | Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure |
| title_full | Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure |
| title_fullStr | Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure |
| title_full_unstemmed | Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure |
| title_short | Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure |
| title_sort | implications of the hemodynamic optimization approach guided by right heart catheterization in patients with severe heart failure |
| topic | heart failure treatment hemodynamic optimization |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2002000300001 |
| work_keys_str_mv | AT luiserohde implicationsofthehemodynamicoptimizationapproachguidedbyrightheartcatheterizationinpatientswithsevereheartfailure AT thiagofurian implicationsofthehemodynamicoptimizationapproachguidedbyrightheartcatheterizationinpatientswithsevereheartfailure AT candicecampos implicationsofthehemodynamicoptimizationapproachguidedbyrightheartcatheterizationinpatientswithsevereheartfailure AT andreiabiolo implicationsofthehemodynamicoptimizationapproachguidedbyrightheartcatheterizationinpatientswithsevereheartfailure AT eneidarabelo implicationsofthehemodynamicoptimizationapproachguidedbyrightheartcatheterizationinpatientswithsevereheartfailure AT murilofoppa implicationsofthehemodynamicoptimizationapproachguidedbyrightheartcatheterizationinpatientswithsevereheartfailure AT nadineclausell implicationsofthehemodynamicoptimizationapproachguidedbyrightheartcatheterizationinpatientswithsevereheartfailure |