Continuous hemodynamic monitoring in heart failure.
Chronic congestive heart failure is associated with high morbidity and mortality, frequent hospital admissions, and high treatment costs. As the prevalence and incidence of the disease are increasing, there is a clear need to improve the management of heart failure patients. Continuous hemodynamic monitoring with an implanted device is technically feasible and safe. It provides reliable information on central hemodynamic parameters and allows for analysis of long-term hemodynamic trends. It has been suggested that continuous hemodynamic monitoring might improve the management of patients with chronic heart failure. This article describes the technical details of the monitoring system and presents possible clinical applications, with a focus on beta-blocker therapy, diuretics, and volume management. A case is reported, illustrating how hemodynamic long-term trends might add valuable information during up-titration of beta-blockers. Future implications of hemodynamic monitoring are discussed.
Braunschweig
Frieder
F
Department of Cardiology, Karolinska Hospital, Stockholm, Sweden. frieder.braunschweig@ks.se
Linde
Cecilia
C
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D015924:Blood Pressure Monitors; D001810:Blood Volume / Q000187:drug effects; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*
D000319:Adrenergic beta-Antagonists; D004232:Diuretics