Heart failure & cardiomyopathies
Non-invasive quantification of haemodynamic imbalance in acute heart failure
- non-invasive physiology-guided approach based on venous return (VR)-cardiac output (CO) balance
Authors' conclusion
AHF may represent a failure of circulatory compensation in which venous return loading exceeds the capacity of forward flow. A non-invasive VR-CO framework reveals a continuum from compensated to buffered to overtly decompensated states and identifies a previously unrecognized highly buffered state preceding clinical deterioration. This physiology-guided approach may enable earlier detection of circulatory instability and provide a quantitative framework for risk stratification and therapeutic monitoring.
Study context
- Population
- Patients with chronic heart failure, hypertensive heart disease, or acute heart failure (AHF)patients analysed
- Participants
- 193 patients
- Comparison
- 193 patients with chronic heart failure, hypertensive heart disease, or AHF were analysed to evaluate VR-CO mismatch using a composite mismatch index
Main finding
As reported in the abstract
Lower-mismatch component, mean ± SD
2.25 ± .96
Higher-mismatch component, mean ± SD
5.25 ± 2.61
Further findings
Intermediate states
- Increasing mismatch while maintaining relatively preserved forward flow, consistent with buffered circulatory states
Haemodynamic mismatch without clinical congestion
- A subset of patients exhibited marked haemodynamic mismatch without clinical congestion, representing a highly buffered pre-decompensated state
Original publication
Summarised from the published abstract; every number is checked against it