Author + information
- Thach Nguyen1,2,
- Advait Soni1,
- Ryan Phan3,
- Nam T. Truong4,
- Tung Mai5,
- Faisal Latif6 and
- Duane Pinto7
- 1St Mary Medical Center, Hobart IN, USA
- 2Methodist Hospital, Merrillville IN, USA
- 3Notre Dame University, South Bend IN, USA
- 4Tan Tao University Medical School, Long An, Vietnam
- 5Detroit Medical Center, Detroit MI, USA
- 6Oklahoma University Medical Center, OKC OK
- 7Beth Israel Deaconess Medical Center, Boston MA, USA
Current treatment of heart failure (HF) is based on diuresis, angiotensin converting enzyme inhibition), betablockade (BB). Which medications really made a difference in the improvement of symptom?
All patients were of NYHA FC 3 and received optimal therapy and a device to measure the pulmonary artery diastolic pressure (PADP). It is called the CardioMEMS? HF System. The PADP was measured everyday through to a monitoring device. The results were tabulated and sent every week to the cardiologists of the patient. Based on the results, the medications of the patients were changed, discontinued or the doses were increased or decreased accordingly. As the patient was on ACEI and BB, the 2 medications which were frequently changed were diuretics and long acting nitroglycerin.
20 patients were enrolled from January 2015 to April 2016. All came with New York Heart Association Functional Class 3 and received the CardioMEMS? HF System. With treatment, the patients improved a lot, however, there was slow lowering of the PADP. The patients had less SOB and a lot of weight loss. Smaller size of the abdomen, So the mechanism of improvement in HF is by removing the extravascular fluid. There is mild change in the PADP unless the causes of cardiomyopathy were reversed.
At the present time, the success treatment of a patient with NYHA FC 3, is to control the problem with BB and ACEI. However, the long term symptomatic improvement depends on the removal of extravascular fluid and advances on the rehab program.