Key result
Higher LVFP is linked to reduced fluid responsiveness in acute HFrEF.
Why the study?
In patients with acute HFrEF, elevated LVFP and impaired contractility often limit response to preload changes, prompting investigation into the relationship between LVFP and fluid responsiveness.
Does left ventricular filling pressure correlate with fluid responsiveness in patients with acute HFrEF?
Cross-Sectional (n=65)
Does left ventricular filling pressure correlate with fluid responsiveness in patients with acute HFrEF?
Higher left ventricular filling pressure is moderately associated with reduced fluid responsiveness in acute HFrEF, highlighting the utility of echocardiography for individualized volume management.
Echocardiographic LVFP assessment may help identify fluid non-responders in acute HFrEF; leaves open prospective validation before clinical adoption.
Background: Fluid responsiveness describes the capacity of the myocardium to raise stroke volume by at least 10% when ventricular filling is increased, consistent with the principle outlined by Frank and Starling. In patients with acute heart failure with reduced ejection fraction (HFrEF), elevated left ventricular filling pressure (LVFP) and impaired contractility frequently place the ventricle on the flattened segment of this relationship, resulting in a limited response to preload changes. Objectives: To investigate the relationship between LVFP and fluid responsiveness in patients with acute HFrEF. Methods: This study aimed to explore the link between LVFP and fluid responsiveness using echocardiography to track velocity–time integral (VTI) changes during a passive leg raising (PLR) maneuver. A cross-sectional observational design was applied, enrolling patients admitted with acute HFrEF from December 2024 to April 2025. LVFP was estimated through echocardiographic indices of E/A ratio, E/e' and calculated pulmonary capillary wedge pressure (PCWP). A ≥ 10% increase in VTI after PLR indicated fluid responsiveness. Results: Of 65 participants, 37 (57%) were non-responders. The non-responder group had higher LVFP values across all indices, namely: E/A, E/e', and PCWP. Fluid responsiveness correlated significantly with E velocity, E/A ratio, and E/e'. Conclusion: Higher LVFP is moderately associated with reduced fluid responsiveness in acute HFrEF, underscoring the value of echocardiographic indices in guiding individualized volume management.
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Tamba et al. (2026) conducted a cross-sectional in Acute heart failure with reduced ejection fraction (HFrEF) (n=65). Elevated left ventricular filling pressure (LVFP) was evaluated on Fluid responsiveness (≥ 10% increase in velocity-time integral after passive leg raising). Higher left ventricular filling pressure was significantly associated with reduced fluid responsiveness (57% of patients were non-responders) in acute HFrEF.
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