Nghiệm pháp mới đánh giá thể tích dịch ở người suy tim cấp hoặc mạn

Test which confirms acute on chronic systolic heart failure Thach Nguyen, Advait Soni, Ryan Phan, Tri Pham*, Tung Mai, Gianluca Rigatelli 1... Background - The current way to diagnose

Test which confirms

acute on chronic

systolic heart failure

Thach Nguyen, Advait Soni, Ryan Phan, Tri Pham*, Tung Mai, Gianluca Rigatelli

1

Background

- The current way to diagnose an acute decompensation on chronic heart failure bases on the state of fluid in the body

- Traditional methods to diagnose acute

decompensation are complicated

3

Objectives

Acute symptomatic heartfailure (with shortness of breath) happends when the capacitance of the intravascular compartment is overwhelmed

=> New test assesses intravenous fluid

4

Methods

- Fluid overload examination: in the extravascular system and in the venous system

- The study group underwent the SEFV (Size and

Expansibility of the Femoral Vein) test

5

SEFV test

The first principle: the volume of blood going

through the femoral artery and returning through the common femoral vein should be the same

6

SEFV test

The second principle: The veins have high

compliance => can contain more blood while the arteries have high vascular tone => keep constant pressure

7

10

Normal person at rest

The size of the

femoral vein is a

little larger than the

size of the common

femoral artery

11

Normal person when cough

The expansion of the femoral vein to less than 2 times larger than the baseline

12

Abnormal person when cough Abnormal = dehydration or hypovolemia

There is no minimal expansion of the femoral vein

13

Fluid overload in the veinous system

14

15

Results

50 patients with severe SOB were diagnosed with dilated cardiomyopathy with low ejection fraction (mean EF = 36%)

17

Conclusions

- The SEFV test was more accurate in confirming the diagnosis of acute decompensated heart failure than traditional diagnosis

- The diagnosis was based on the significant fluid overload in the venous system as evidenced by the SEFV test

20

Thank you for your attention!

21