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Improvements in RV dysfunction small following unloading therapy for decompensated HF
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Unloading therapy for patients with advanced decompensated HF led to smaller than expected improvements in right ventricular function, according to a presentation at the Heart Failure Society of America 13th Annual Scientific Meeting in Boston.
Researchers included 40 patients with decompensated HF and a LVEF <40%. Patients were included if they had an anticipated need for ≥24 hours of diuretics and underwent transthoracic 2D and Doppler echocardiography at baseline and following the administration of unloading therapies at optimal volume status. The mean duration of unloading therapy was 9.0 days.
The researchers reported that only eight patients had hemodynamic information available at both baseline and follow-up. Right atrial filling pressure was reduced by a mean of –8 mm Hg (P=.004) and pulmonary capillary wedge pressure fell by a mean of –14 mm Hg (P=.03) following unloading therapy. The researchers also reported that left atrial volume was diminished from 66 mL to 59 mL (P=.02), as well as mitral regurgitation severity, which decreased from moderate to mild (P=.02). There was no change in mitral filling factor (P=.27). Reductions in several quantitative measures of right ventricular function such as systolic pulmonary artery pressure (P=.0002) and tricuspid regurgitation severity (P=.01) were reported. – by Eric Raible
For more information:
- Palardy M. #023. Presented at: Heart Failure Society of America 13th Annual Scientific Meeting; Sept. 13-16, 2009; Boston.