New mechanism explaining fluid overload in patient with diastolic heart failure or heart failure patient with preserved ejection fraction: When the veins cause hypertension in the artery

 NEW MECHANISM EXPLAINING FLUID OVERLOAD 
IN PATIENT WITH DIASTOLIC HEART FAILURE OR 
HEART FAILURE PATIENT WITH PRESERVED 
EJECTION FRACTION : WHEN THE VEINS CAUSE 
HYPERTENSION IN THE ARTERY 
Presenter : Dinh Tran Xuan Truong 
OUTLINE 
1.BACKGROUND 
2.METHODS 
3.RESULT 
4.CONCLUSION 
BACKGROUND 
Heart failure 
(HF) 
Ejection of blood 
Ventricular filling 
Structural and 
functional 
impairment 
HFpEF 
BACKGROUND 
FLUID OVERLOAD 
Intravascular (mainly 
venous) compartment 
Extravascular compartment 
METHODS 
 CHOOSE SAMPLE 
 Time : From January 2015 to April 2016 
 Number of patient : 25 patients 
 Dx : HFpEF 
 CLASSIFY THE PATIENTS 
 Location of fluid overload depending on SEFV test 
 Present with pulmonary HTN or prediction of future pulmonary HTN 
 STATISTICAL ANALYSIS: 
 Fisher’s exact test for categorical variables 
 Two-sample t-test for continuous variables 
METHODS 
METHODS 
METHODS 
65% 13% 
More compliant More elastic 
METHODS 
METHODS 
Normal Person 
1 <
𝑅𝐶
𝑅𝐵
< 2 
𝑅𝐵 𝑅𝐶 
METHODS 
𝑹𝑽 ≫ 𝑹𝑨 
𝑹𝑨 
𝑹𝑽 
𝑹𝑨 
𝑹𝑽 
𝑹𝑽 < 𝑹𝑨 
RESULTS 
January 2015  April 2016 
25 patients 
HFpEF 
Size and Expansion of the Femoral Vein (SEFV) test 
20/25 (80%) 
HFpEF 
extravascular fluid overload 
the size of the femoral vein varied from is small or enlarged without good expansion upon cough 
CONCLUSION 
The failure of the 
venous system 
HFpEF 
Fluid overload 
mainly in the 
venous 
compartment 
Larger scale of clinical trial 
or registries confirming this 
new concept are needed. 
Thank You