TY - JOUR
T1 - Echo-Doppler and clinical evaluations to define hemodynamic profile in patients with chronic heart failure
T2 - Accuracy and influence on therapeutic management
AU - Capomolla, Soccorso
AU - Ceresa, Monica
AU - Pinna, GianDomenico
AU - Maestri, Roberto
AU - La Rovere, Maria Teresa
AU - Febo, Oreste
AU - Rossi, Angelo
AU - Paganini, Vincenzo
AU - Caporotondi, Angelo
AU - Guazzotti, Giampaolo
AU - Gnemmi, Marco
AU - Mortara, Andrea
AU - Cobelli, Franco
PY - 2005/6
Y1 - 2005/6
N2 - Background: Correct classification of chronic heart failure (CHF) patients by dual evidence of congestion and adequate perfusion is the primary clinical focus for management. Objectives: To evaluate the accuracy of echo-Doppler compared with clinical evaluation in determining the hemodynamic profile of patients with CHF; and to compare therapeutic changes based on hemodynamic or echo-Doppler findings. Methods: Three hundred and sixty-six consecutive CHF patients (ejection fraction 25±7%) in sinus rhythm, undergoing evaluation for cardiac transplantation, underwent physical examination prior to right heart catheterization and echo-Doppler studies. Subsequently, patients were randomized to therapeutic optimization using either right heart catheterization or echo-Doppler data. The end-points were: identification of low cardiac output (cardiac index 2); high pulmonary wedge pressure (PWP >18 mm Hg); high right atrial pressure (RAP >5 mm Hg) and analysis of therapeutic changes made in response to the right heart catheterization and echo-Doppler studies. Results: Echo-Doppler showed better accuracy in estimating abnormal hemodynamic indices than clinical variables (cardiac index 2: echo positive predictive accuracy (PPA) 98% vs. clinical PPA 52% p18 mm Hg: echo PPA 85% vs. clinical PPA 76% p=0.0011; RAP >5 mm Hg: echo PPA 82% vs. clinical PPA 57% p
AB - Background: Correct classification of chronic heart failure (CHF) patients by dual evidence of congestion and adequate perfusion is the primary clinical focus for management. Objectives: To evaluate the accuracy of echo-Doppler compared with clinical evaluation in determining the hemodynamic profile of patients with CHF; and to compare therapeutic changes based on hemodynamic or echo-Doppler findings. Methods: Three hundred and sixty-six consecutive CHF patients (ejection fraction 25±7%) in sinus rhythm, undergoing evaluation for cardiac transplantation, underwent physical examination prior to right heart catheterization and echo-Doppler studies. Subsequently, patients were randomized to therapeutic optimization using either right heart catheterization or echo-Doppler data. The end-points were: identification of low cardiac output (cardiac index 2); high pulmonary wedge pressure (PWP >18 mm Hg); high right atrial pressure (RAP >5 mm Hg) and analysis of therapeutic changes made in response to the right heart catheterization and echo-Doppler studies. Results: Echo-Doppler showed better accuracy in estimating abnormal hemodynamic indices than clinical variables (cardiac index 2: echo positive predictive accuracy (PPA) 98% vs. clinical PPA 52% p18 mm Hg: echo PPA 85% vs. clinical PPA 76% p=0.0011; RAP >5 mm Hg: echo PPA 82% vs. clinical PPA 57% p
KW - Chronic heart failure
KW - Clinical signs
KW - Echo-Doppler
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U2 - 10.1016/j.ejheart.2004.07.013
DO - 10.1016/j.ejheart.2004.07.013
M3 - Article
C2 - 15921804
AN - SCOPUS:19544372227
VL - 7
SP - 624
EP - 630
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 4
ER -