title: Walking the tightrope: Using quantitative Doppler echocardiography to optimize ventricular filling pressures in patients hospitalized for acute heart failure.
abstract: Acutely decompensated heart failure (HF), one of the most common reasons for hospitalization, places an intense economic pressure on the health care system and adversely affects outcome of HF patients. Due to lack of reliable clinical tools to assess and monitor hemodynamics, accurate judgment on cardiac preload remains a challenge and complicates current inpatient HF management. In this review, we discuss the emerging role of real-time quantitative Doppler echocardiography (DE) in identifying inappropriate cardiac preload, monitoring volume status during the management, and improving quality of care in patients with acute HF. We illustrate the utilization of DE in common clinical scenarios, propose stepwise algorithms to effectively utilize serial quantitative DE in the bedside care, and discuss obstacles and prospects of quantitative DE utilization in HF management. These efforts will further prompt the development of multi-center prospective studies to define and validate the specific roles of quantitative DE in reducing hospitalization time and improving outcome of HF patients.
authors.affiliation: Department of Cardiology, Sun Yat-Sen Memorial Hospital, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Lei
authors.affiliation: Department of Medicine, State University of New York, USA.
authors.forename: Amit S
authors.initials: AS
authors.lastname: Dhamoon
authors.affiliation: Department of Cardiology, Sun Yat-Sen Memorial Hospital, China.
authors.forename: Jingfeng
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Medicine, State University of New York, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Iannuzzi
authors.affiliation: Department of Medicine, State University of New York, USA liuk@upstate.edu IannuzzM@upstate.edu.
authors.forename: Kan
authors.initials: K
authors.lastname: Liu
mesh_terms: D000208:Acute Disease; D000368:Aged; D000465:Algorithms; D015150:Echocardiography, Doppler / Q000379:methods*; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013318:Stroke Volume; D017725:Ventricular Pressure / Q000502:physiology*
keywords: Acutely decompensated heart failure; cardiac preload; quantitative doppler echocardiography; ventricular filling pressure