Evaluating the effectiveness of diuretic therapy in the small circle of blood circulation is difficult for clinicians, as distinct from that in the large circle, where it can be assessed by dynamics of peripheral edema and liver size.The aimof the study is to develop non-invasive diagnostics of venous pulmonary hypertension in order to determine the effectiveness of diuretic therapy.In addition to the standard protocol of transthoracic echocardiography, we have investigated the minimum and the maximum pulmonary vein diameter in 30 chronic heart failure patients with III functional class (NYHA) before and after 4 months of standart treatment for chronic heart failure with individual selection of torasemid. All patients received a written consent to participate in the study. After four months of therapy, a significant improvement of the following echocardiographic parameters was revealed (р<0.05): left atrium dimension (from 42±0.88 to 37.9±0.61 mm); left atrium area (from 28.9±0.91 to 24.2±0.83 sm2); maximum pulmonary vein diameter (from 22.4±0.39 to 17.9±0.62 mm); minimum pulmonary vein diameter (from 11.9±0.27 to 8.4±0.6 mm).Thus, the transthoracic echocardiography measurement of the pulmonary vein diameter is a non-invasive objective diagnostic of venous pulmonary hypertension for evaluation diuretic therapy effectiveness.
Non-invasive assessment of cardiac hemodynamics in patients with advanced cancer and with chronic heart failure: a pilot feasibility study