• Am J Emerg Med · May 2014

    Monitoring the response to treatment of acute heart failure patients by ultrasonographic inferior vena cava collapsibility index.

    • Özcan Yavaşi, Erden Erol Ünlüer, Kamil Kayayurt, Selim Ekinci, Caner Sağlam, Nebi Sürüm, Mehmet Hicri Köseoğlu, and Murat Yeşil.
    • Recep Tayyip Erdoğan University, Rize Research and Training Hospital, Rize, Turkey.
    • Am J Emerg Med. 2014 May 1; 32 (5): 403-7.

    ObjectiveOur aim was to determine if N-terminal pro-brain natriuretic peptide (NT-proBNP) or sonographic measurements of inferior vena caval (IVC) diameters and collapsibility index (IVC-CI) have a role in the monitoring of acute heart failure (AHF) therapy.MethodsInferior vena caval diameters of 50 healthy people (control group) were measured to determine the normal values of the IVC parameters. We then prospectively enrolled patients who were admitted to the emergency department (ED) with a primary diagnosis of AHF. At presentation, IVC diameters were measured during expiration and inspiration, and blood was drawn for NT-proBNP. We repeated the measurement of the IVC parameters and collected a second blood sample 12 hours after the therapy was administered. The data were analyzed in SPSS 15.0 (IBM, Armonk, NY) using the Student t test and Mann-Whitney U test.ResultsA total of 97 subjects were enrolled: 47 in the patient group and 50 in the control group. The mean IVC during expiration was 2.10 ± 0.37 cm before and 1.57 ± 0.24 cm after the therapy (P < .001). The mean IVC during inspiration was 1.63 ± 0.40 cm before and 0.90 ± 0.26 cm after the therapy (P < .001). The mean IVC-CI rose from 22.80% ± 10.97% to 43.09% ± 13.63% (P < .001). After the therapy, there was no difference between the IVC-CI of the patients and controls (P = .246). There was no significant change in the mean NT-proBNP levels after the therapy.ConclusionInferior vena caval collapsibility index may be helpful in monitoring AHF patients' responses to therapy in the ED.Copyright © 2014 Elsevier Inc. All rights reserved.

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