title: Monitoring the response to treatment of acute heart failure patients by ultrasonographic inferior vena cava collapsibility index.
abstract: OBJECTIVE
  Our aim was to determine if N-terminal pro-brain natriuretic peptide (NT-proBNP) or sonographic measurements of inferior vena caval (IVC) diameters and collapsibility index (IVC-CI) have a role in the monitoring of acute heart failure (AHF) therapy.
  
  
  METHODS
  Inferior vena caval diameters of 50 healthy people (control group) were measured to determine the normal values of the IVC parameters. We then prospectively enrolled patients who were admitted to the emergency department (ED) with a primary diagnosis of AHF. At presentation, IVC diameters were measured during expiration and inspiration, and blood was drawn for NT-proBNP. We repeated the measurement of the IVC parameters and collected a second blood sample 12 hours after the therapy was administered. The data were analyzed in SPSS 15.0 (IBM, Armonk, NY) using the Student t test and Mann-Whitney U test.
  
  
  RESULTS
  A total of 97 subjects were enrolled: 47 in the patient group and 50 in the control group. The mean IVC during expiration was 2.10 ± 0.37 cm before and 1.57 ± 0.24 cm after the therapy (P < .001). The mean IVC during inspiration was 1.63 ± 0.40 cm before and 0.90 ± 0.26 cm after the therapy (P < .001). The mean IVC-CI rose from 22.80% ± 10.97% to 43.09% ± 13.63% (P < .001). After the therapy, there was no difference between the IVC-CI of the patients and controls (P = .246). There was no significant change in the mean NT-proBNP levels after the therapy.
  
  
  CONCLUSIONS
  Inferior vena caval collapsibility index may be helpful in monitoring AHF patients' responses to therapy in the ED.
authors.affiliation: Recep Tayyip Erdoğan University, Rize Research and Training Hospital, Rize, Turkey.
authors.forename: Özcan
authors.initials: Ö
authors.lastname: Yavaşi
authors.affiliation: Katip Çelebi University, İzmir Atatürk Research and Training Hospital, İzmir, Turkey. Electronic address: erolerdenun@yahoo.com.
authors.forename: Erden Erol
authors.initials: EE
authors.lastname: Ünlüer
authors.affiliation: Recep Tayyip Erdoğan University, Rize Research and Training Hospital, Rize, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Kayayurt
authors.affiliation: İzmir Menemen State Hospital, İzmir, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Ekinci
authors.affiliation: Diyarbakır Research and Training Hospital, Diyarbakır, Turkey.
authors.forename: Caner
authors.initials: C
authors.lastname: Sağlam
authors.affiliation: Uşak State Hospital, Uşak, Turkey.
authors.forename: Nebi
authors.initials: N
authors.lastname: Sürüm
authors.affiliation: Giresun University, Giresun, Turkey.
authors.forename: Mehmet Hicri
authors.initials: MH
authors.lastname: Köseoğlu
authors.affiliation: Katip Çelebi University, İzmir Atatürk Research and Training Hospital, İzmir, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yeşil
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004452:Echocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011446:Prospective Studies; D014421:Turkey; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain