Nghiệm pháp mới đánh giá thể tích dịch ở người suy tim cấp hoặc mạn

Test which confirms
acute on chronic
systolic heart failure
Thach Nguyen, Advait Soni, Ryan Phan,
Tri Pham*, Tung Mai, Gianluca Rigatelli

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Contents
• Background
• Objectives
• Methods
– SEFV test
– The study

• Results

• Conclusion

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Background
- The current way to diagnose an acute

decompensation on chronic heart failure
bases on the state of fluid in the body.

- Traditional methods to diagnose acute
decompensation are complicated

3


Objectives
Acute

symptomatic

heartfailure

(with

shortness of breath) happends when the
capacitance of the intravascular compartment is

overwhelmed.
=> New test assesses intravenous fluid.

4


Methods
- Fluid overload examination: in the extravascular
system and in the venous system.
- The study group underwent the SEFV (Size and
Expansibility of the Femoral Vein) test

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SEFV test
The first principle: the volume of blood going
through the femoral artery and returning through

the common femoral vein should be the same.

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SEFV test
The second principle: The veins have high
compliance => can contain more blood while

the arteries have high vascular tone => keep
constant pressure.

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8


SEFV test
Size of the femoral vein can change from the same

size to the femoral artery or to be bigger.
Estimate the amount of blood in the arteries and
veins through ultrasound examination.
SEFV is the ultrasound study examining the size of

the femoral vein and its expansion with cough.

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10


Normal person at rest
The size of the
femoral vein is a
little larger than the
size of the common
femoral artery

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Normal person when cough
The expansion of the femoral vein to less than 2 times
larger than the baseline.

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Abnormal person when cough
Abnormal = dehydration or hypovolemia
There is no minimal expansion of the femoral vein

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Fluid overload in the veinous system

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The study
Group A
Patients diagnosed
based on traditional
method

Group B
Patients diagnosed
with the new SEFV
results

All patients also had beta natriuretic
peptide (BNP) level measured

15


Enroll

Divide into 2 groups

SEFV/traditional method

Collect data

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Results
50 patients with severe SOB were diagnosed with
dilated cardiomyopathy with low ejection fraction
(mean EF = 36%)

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Results
Diseases

Percentage

COPD

30%

Chronic Kidney Disease

34%

Liver Cirrhosis

4%

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Results
HF diagnosis

Percentage

BNP test

50%

SEFV test

95%

Clinical diagnosis

70%

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Conclusions
- The SEFV test was more accurate in confirming the

diagnosis of acute decompensated heart failure than
traditional diagnosis.
- The diagnosis was based on the significant fluid
overload in the venous system as evidenced by the

SEFV test.

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Thank you
for your attention!

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