Noninvasive Evaluation of Systemic Vascular Resistance and Cardiac Output Would Provide the Most Optimal Drug Selection in Patients with Acute Decompensated Heart Failure

2009 ◽  
Vol 15 (6) ◽  
pp. S107-S108
Author(s):  
Masataka Watanabe ◽  
Kazuhiko Hashimura ◽  
Takahiro Ohara ◽  
Makoto Amaki ◽  
Takuya Hasegawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Noninvasive Evaluation ◽  
Drug Selection ◽  
Optimal Drug

Clinical Significance of Systemic Vascular Resistance in Acute Decompensated Heart Failure

2009 ◽  
Vol 15 (7) ◽  
pp. S172
Author(s):  
Tomohiro Mizutani ◽  
Takayuki Inomata ◽  
Tomoyoshi Yanagisawa ◽  
Emi Maekawa ◽  
Takashi Naruke ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systemic Vascular Resistance ◽  
Clinical Significance ◽  
Vascular Resistance ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure

scholarly journals Bioimpedance Vector Analysis for Heart Failure: Should We Put It on the Agenda?

2021 ◽  
Vol 8 ◽  
Author(s):  
Bo Liang ◽  
Rui Li ◽  
Jia-Yue Bai ◽  
Ning Gu
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Clinical Diagnosis ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Clinical Syndrome ◽  
Vector Analysis ◽  
Diagnosis And Management ◽  
Volume Assessment ◽  
Intracardiac Pressure

Heart failure is a clinical syndrome, resulting in increased intracardiac pressure and/or decreased cardiac output under rest or stress. In acute decompensated heart failure, volume assessment is essential for clinical diagnosis and management. More and more evidence shows the advantages of bioimpedance vector analysis in this issue. Here, we critically present a brief review of bioimpedance vector analysis in the prediction and management of heart failure to give a reference to clinical physicians and guideline makers.

scholarly journals Acute Heart Failure Exacerbation with Cardiogenic Shock and Elevated Systemic Vascular Resistance Treated with a Combination of Nicardipine and Dobutamine Therapy

2017 ◽  
Vol 2017 ◽  
pp. 1-2
Author(s):  
Lydia E. Issac ◽  
Setri Fugar ◽  
Naser Yamani ◽  
Burhan Mohamedali
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Severe Hypertension ◽  
Subsequent Recovery ◽  
History Of ◽  
Heart Failure Exacerbation

Acute heart failure is a common reason for hospital admission and is usually caused by decreased cardiac output either as a result of an intrinsic cardiac issue or as a result of severe hypertension with elevated afterload. We present a patient with a history of HFrEF who presented with acute heart failure, found to have hypotension requiring Dobutamine support and an elevated systemic vascular resistance requiring Nicardipine drip, with subsequent recovery of cardiac function.

Intra-Aortic Balloon Pumping in Acute Decompensated Heart Failure With Hypoperfusion: From Pathophysiology to Clinical Practice

2021 ◽  
Author(s):  
Luca Baldetti ◽  
Matteo Pagnesi ◽  
Mario Gramegna ◽  
Alessandro Belletti ◽  
Alessandro Beneduce ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiac Output ◽  
Cardiogenic Shock ◽  
Acute Decompensated Heart Failure ◽  
Therapeutic Option ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Ventricular Afterload ◽  
Clinical Scenarios

Trials on intra-aortic balloon pump (IABP) use in cardiogenic shock related to acute myocardial infarction have shown disappointing results. The role of IABP in cardiogenic shock treatment remains unclear, and new (potentially more potent) mechanical circulatory supports with arguably larger device profile are emerging. A reappraisal of the physiological premises of intra-aortic counterpulsation may underpin the rationale to maintain IABP as a valuable therapeutic option for patients with acute decompensated heart failure and tissue hypoperfusion. Several pathophysiological features differ between myocardial infarction- and acute decompensated heart failure–related hypoperfusion, encompassing cardiogenic shock severity, filling status, systemic vascular resistances rise, and adaptation to chronic (if preexisting) left ventricular dysfunction. IABP combines a more substantial effect on left ventricular afterload with a modest increase in cardiac output and would therefore be most suitable in clinical scenarios characterized by a disproportionate increase in afterload without profound hemodynamic compromise. The acute decompensated heart failure syndrome is characterized by exquisite afterload-sensitivity of cardiac output and may be an ideal setting for counterpulsation. Several hemodynamic variables have been shown to predict response to IABP within this scenario, potentially guiding appropriate patient selection. Finally, acute decompensated heart failure with hypoperfusion may frequently represent an end stage in the heart failure history: IABP may provide sufficient hemodynamic support and prompt end-organ function recovery in view of more definitive heart replacement therapies while preserving ambulation when used with a transaxillary approach.

scholarly journals Haemodynamic effects of aliskiren in decompensated severe heart failure

2011 ◽  
Vol 13 (1) ◽  
pp. 128-132 ◽  
Author(s):  
Euler O Brancalhao ◽  
Marcelo E Ochiai ◽  
Juliano N Cardoso ◽  
Kelly R Vieira ◽  
Raphael N Puig ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Cardiac Index ◽  
Systolic Blood Pressure ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Ace Inhibitors ◽  
Severe Heart Failure ◽  
Decompensated Heart Failure ◽  
Haemodynamic Effects

Aim: The renin–angiotensin–aldosterone system (RAAS) has dual pathways to angiotensin II production; therefore, multiple blockages may be useful in heart failure. In this study, we evaluated the short-term haemodynamic effects of aliskiren, a direct renin inhibitor, in patients with decompensated severe heart failure who were also taking angiotensin-converting enzyme (ACE) inhibitors. Materials and methods: A total of 16 patients (14 men, two women, mean age: 60.3 years) were enrolled in the study. The inclusion criteria included hospitalisation due to decompensated heart failure, ACE inhibitor use, and an ejection fraction < 40% (mean: 21.9 ± 6.7%). The exclusion criteria were: creatinine > 2.0 mg/dl, cardiac pacemaker, serum K+ > 5.5 mEq/l, and systolic blood pressure < 70 mmHg. Patients either received 150 mg/d aliskiren for 7 days (aliskiren group, n = 10) or did not receive aliskiren (control group, n = 6). Primary end points were systemic vascular resistance and cardiac index values. Repeated-measures analysis of variance (ANOVA) was used to assess variables before and after intervention. A two-sided p-value < 0.05 was considered statistically significant. Results: Compared to pre-intervention levels, systemic vascular resistance was reduced by 20.4% in aliskiren patients, but it increased by 2.9% in control patients ( p = 0.038). The cardiac index was not significantly increased by 19.0% in aliskiren patients, but decreased by 8.4% in control patients ( p = 0.127). No differences in the pulmonary capillary or systolic blood pressure values were observed between the groups. Conclusion: Aliskiren use reduced systemic vascular resistance in patients with decompensated heart failure taking ACE inhibitors.

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