Background: Fluid responsiveness is an important topic for clinicians. Aggressive hydration has been shown to lead to worse outcomes. The aim of this study was to investigate the sensitivity and specificity of mitral valve (MV) velocity time integral (VTI) as a non-invasive marker of volume responsiveness.
Methods: This was a prospective observational study conducted in a tertiary emergency department. End-stage renal disease patients presenting to the emergency department requiring emergent hemodialysis were enrolled. A focused echocardiogram was done on enrolled patients. Two sets of measurements were obtained before and after hemodialysis. During each scanning session, the left ventricular outflow tract and the mitral valve VTI were obtained before and after a passive leg raise maneuver.
Results: 54 patients were enrolled, of which, 30 (55%) were male. The mean age was 47.4 years. The mean volume of fluid removed was 3.89 ± 0.91 L. All patients had a diagnosis of hypertension, 22 (41%) patients were diabetic, 14 (26%) patients had coronary artery disease, and 19 (35%) patients had congestive heart failure. The mean change in LVOT VTI was 1.83% (95% CI 0.12-3.55) in the pre-dialysis group and 15.05% (95% CI 12.76-17.34) in the post-hemodialysis cohort. The mean change in MV VTI was 3.74% (95% CI 2.84-4.65) in the pre-dialysis cohort and 12.95% (95% CI 11.50-14.39) in the post-dialysis cohort. For patients who had < 4 L removed, the mean delta LVOT VTI post-hemodialysis was 12.64% (95% CI 9.79-15.49) and the mean delta MV VTI was 10.48% (95% CI 8.28-12.69). For patients who had > 4 L removed, the mean delta LVOT VTI was 16.84% (95% CI 13.47-20.22) and the mean MV VTI was 14.77% (95% CI 13.03-16.51). Mitral valve VTI with PLR was found to have a sensitivity of 89.18% and a specificity of 94.11% in detecting volume responsiveness.
Conclusion: Mitral valve velocity time integral in conjunction with passive leg raise seem to correlate with volume responsiveness in hemodialysis patients.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275151 | PMC |
| http://dx.doi.org/10.1186/s13089-018-0114-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pimobendan oral solution is bioequivalent to pimobendan chewable tablets in beagle dogs.
J Vet Intern Med
January 2025
Boehringer Ingelheim Pharma GmbH & Co., Ingelheim, Germany.
Background: Myxomatous mitral valve disease (MMVD) is frequently diagnosed in small breed dogs. Pimobendan oral solution has been developed to improve dosing accuracy in small and toy breed dogs.
Hypothesis/objectives: Demonstrate bioequivalence of pimobendan oral solution with pimobendan chewable tablets using a pharmacokinetic and a pharmacodynamic study in healthy purpose bred dogs.
is rarely associated with neurological manifestations. This report describes a rare case of endocarditis complicated by a cerebral stroke caused by . We also briefly reviewed the neurological clinical spectrum of disease described in the literature.
View Article and Find Full Text PDFLingual artery thrombosis as a presentation of infective endocarditis in a pregnant patient: a case report.
Eur Heart J Case Rep
January 2025
Department of Cardiology, Clínica Alemana de Santiago, Avenida Manquehue Norte #1499, 7650568 Vitacura, Chile.
Background: Infective endocarditis during pregnancy is a rare condition that compromises the health of both the mother and the foetus, presenting high rates of morbidity and mortality. The clinical manifestations of this disease are varied, with embolic phenomena being a frequent presentation.
Case Summary: We report the case of a Hispanic 37-year-old patient, at 29 weeks of pregnancy, with no known cardiovascular history, who presented with 48 h of sudden mandibular and lingual pain.
Human infective endocarditis and septic shock caused by Streptococcus suis serotype 1.
BMC Infect Dis
January 2025
Wuming Hospital of Guangxi Medical University, Nanning, China.
Streptococcus suis(SS) infection is a zoonotic acute infectious disease, SS infective endocarditis is relatively rare, there is no case report of Streptococcus suis Serotype 1(SS1) causing mitral valve infection.The rapid progression of this patient's infection and the severe damage to the valve structure differ from the previous understanding of the relatively low virulence of SS1. Early diagnosis and selection of the correct antibiotic treatment according to the drug sensitivity is very important.
View Article and Find Full Text PDFCardiac papillary fibroelastoma involving the mitral valve: A case report.
Medicine (Baltimore)
January 2025
Ultrasound Medical Center, Second Hospital of Lanzhou University, Lanzhou, China.
Rationale: Cardiac papillary fibroelastoma (CPF) is a rare cardiac tumor that can lead to severe and potentially fatal complications such as stroke, myocardial infarction, and sudden cardiac death. The rarity of CPF makes it challenging for clinicians to diagnose and treat, highlighting the importance of timely and accurate diagnosis to prevent catastrophic outcomes. This case report aims to contribute to the clinical understanding of CPF involving the mitral valve (MV), providing insights into diagnosis and treatment strategies.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!