Koldenhof, T. (Tim) (2019) Use of inferior vena cava dimensions in the early detection of change in volume status in patients with chronic heart failure. thesis, Medicine.
Full text available on request.Abstract
Objectives: In this study we aimed to determine the effect of furosemide withdrawal and reinitiation on inferior vena cava (IVC) diameters in stable chronic heart failure (HF) patients. Background: HF patients are frequently hospitalized with signs of congestion. Inferior vena cava diameter and collapsibility are markers of congestion and can be used to predict hospital admissions and mortality. Material and methods: In this study 30 stable chronic HF patients were included. The patients were in a presumed euvolemic state on standard furosemide treatment (40mg or 80mg). Patients underwent a 7 day diuretic manipulation protocol. At baseline furosemide treatment was withdrawn and reinstated after 72 hours. Plasma brain natriuretic peptide (BNP), atrial natriuretic peptide (ANP) and ultrasound IVC diameter assessment was carried out at different time points before, during and after diuretic withdrawal. Results: Diuretic withdrawal resulted in an increase of IVC diameters in expiration (p<0.05). After diuretic reinitiation IVC diameters in expiration decreased within 8 hours (p<0.05). BNP responded more slowly and decreased 3 days after diuretic reinitiation (p<0.05). IVC collapsibility showed no significant change during the diuretic manipulation protocol. There was no correlation between IVC diameter and BNP at baseline, while there was a weak correlation between change in BNP and change in IVC after diuretic withdrawal. Conclusion: Subclinical changes in volume status are associated with small, but significant changes in IVC diameters in patients with chronic HF. Changes in IVC diameters were quick and much earlier than changes in BNP. Measurement of IVC diameters can therefore be used in addition to conventional measurements to assess changes in volume status in response to therapy in chronic HF
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Damman, Dr. Kevin Cardioloog and University of Groningen, Department of Cardiology |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:43 |
| Last Modified: | 25 Jun 2020 10:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/454 |
Actions (login required)
 |
View Item |