الفهرس | Only 14 pages are availabe for public view |
Abstract BACKGROUND : Acute exacerbation of chronic heart failure(AECHF) represents an important health problem and economic burden in recent medicine.Despite increasing interest in noninvasive tools for diagnosis and monitoring of therapy in AECHF, its reliability is still debatable . AIM OF THE STUDY : Is to investigate the validity of inferior vena cava (IVC) dynamics as a noninvasive diagnostic and monitoring tool in patients with AECHF . MATERIALS AND METHODS : Thirty patients with exacerbated HF 16 males and 14 females with mean age 50 ±13 years were included.All were in NYHA class and Killip class III-IV and had the clinical criteria of AECHF.All were admitted to ICU and subjected to echcardiographic study and estimation of urinary albumin excretion (UAE) on admission , on days 5 and 10 of treatment . Echcardiographic examination includes : a-Parameters of left ventricular dimnensions and function (PLV). b- IVC-dynamics which include , measurements of IVC diameter at end expiration (D-max), at end inspiration (D-min) and collapse index (CI %). CI % calculated as D-max – D-min / D-max × 100 % . RESULTS : Significant improvement in clinical , PLV and decrease in UAE were observed . Significant decrease in D-min and D-max on day 5 and 10 of treatment .IVC-CI % increased from 11.7 ± 4.8% on admission to 27.7 ± 8.7 % and 47.2 ±8.6 % (P < 0.001) on day 5 and 10 respectively Significant correlations were found between the change in PLV , UAE and IVC-dynamics . CONCLUSION : Estimation of IVC-dynamics seems to be a reliable and reproducible noninvasive diagnostic and hemodynamic monitoring tool in management of AECHF . KEY WORDS : Inferior vena cava dynamics , congestive heart failure , echocardiography , noninvasive , hemodynamic minitoring |