January 1, 1988Catheterization and Cardiovascular Diagnosis
Pulsus alternans induced by inferior vena caval occlusion in man
Why the study?
Does rapid preload reduction via inferior vena caval occlusion induce pulsus alternans and alter left ventricular performance in patients with nonischemic cardiomyopathy?
Population
11 patients with nonischemic cardiomyopathy
Comparison
Inferior vena caval balloon occlusion vs Baseline and beat-to-beat comparison
Design
Cohort
Follow-up
Acute (during procedure)
Authors
Discussion
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Member takes
Implication
Preload reduction may induce pulsus alternans in nonischemic cardiomyopathy; hypothesis-generating and should not yet change practice.
Structured PICO
Does rapid preload reduction via inferior vena caval occlusion induce pulsus alternans and alter left ventricular performance in patients with nonischemic cardiomyopathy?
P
Population
11 patients with nonischemic cardiomyopathy
I
Intervention
Inferior vena caval (IVC) balloon occlusion (rapid preload reduction)
C
Comparator
Baseline (pre-occlusion) and beat-to-beat comparison (strong vs. weak beats)
O
Outcome
Left ventricular performance (systolic and diastolic parameters including LV end-diastolic diameter, LV end-diastolic pressure, peak systolic pressure, fractional shortening, and dP/dt)surrogate
Rapid preload reduction via IVC occlusion can induce pulsus alternans in nonischemic cardiomyopathy, driven by beat-to-beat alternations in preload and intrinsic contractile forces.
Cite This Study
Bashore et al. (1988) studied this question.