Venous Leg Compression for Tissue Decongestion in Patients With Worsening Congestive Heart Failure
Civera, Jose (Universitat de València)
Miñana, Gema (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
De la Espriella, Rafael (Universitat de València)
Santas, Enrique (Universitat de València)
Sastre, Clara (Universitat de València)
Mollar, Anna (Universitat de València)
Conesa, Adriana (Universitat de València)
Martínez, Ana (Universitat de València)
Núñez, Eduardo (Universitat de València)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Núñez, Julio (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Venous leg compression (VLC) with elastic bandages has been proposed as a potentially useful strategy for decreasing tissue congestion. We aimed to evaluate the effect of VLC on short-term changes on intravascular refill, assessed by inferior vena cava (IVC) diameter in patients with worsening heart failure (WHF) requiring parenteral furosemide. Additionally, we sought to evaluate whether early changes in IVC were related to short-term decongestion. This is a prospective study in which we included 20 consecutive ambulatory patients with WHF treated with subcutaneous furosemide and VLC for at least 72 h. The endpoints were (a) short-term changes in IVC, (b) the association between decongestion and 3-h IVC changes following VLC. Changes in continuous endpoints and their longitudinal trajectories were estimated with linear mixed regression models. All analyses were adjusted for multiple comparisons. Following administration of subcutaneous furosemide and VLC, we found a significant increase in 3-h IVC diameter (ΔIVC = 1. 6 mm, CI 95%: 0. 7-2. 5; p < 0. 001), with a greater increase in those with baseline IVC≤21 mm (2. 4 vs. 0. 8 mm; p < 0. 001). 3-h intravascular refill (increase in IVC≥2 mm) was associated with greater decongestion (natriuresis, weight, peripheral edemas, and dyspnea) in those with baseline IVC≤21 mm but not when IVC>21 mm (p < 0. 05 for all comparisons). In this cohort of patients with congestive WHF treated with subcutaneous furosemide and VLC, we found a greater increase in short-term IVC in those with IVC ≤21 mm at baseline. In this subset of patients, a 3-h increase in IVC≥2 mm was associated with greater short-term decongestion.
Grants:	Ministerio de Economía y Competitividad CB16/11/00420 Instituto de Salud Carlos III PI20/00392 Ministerio de Economía y Competitividad CB16/11/00403
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Congestion ; Diuretic efficiency ; Inferior vena cava ; Venous leg compression ; Worsening heart failure
Published in:	Frontiers in Cardiovascular Medicine, Vol. 9 (july 2022) , ISSN 2297-055X

DOI: 10.3389/fcvm.2022.847450
PMID: 35872894

10 p, 2.6 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles