Test which confirms acute on chronic systolic heart failure

Test which confirms 
acute on chronic 
systolic heart failure 
Thach Nguyen, Advait Soni, Ryan Phan, 
Tri Pham*, Tung Mai, Gianluca Rigatelli 
1 
Contents 
• Background 
• Objectives 
• Methods 
– SEFV test 
– The study 
• Results 
• Conclusion 
 2 
Background 
- The current way to diagnose an acute 
decompensation on chronic heart failure 
bases on the state of fluid in the body. 
- Traditional methods to diagnose acute 
decompensation are complicated 
3 
Objectives 
 Acute symptomatic heartfailure (with 
shortness of breath) happends when the 
capacitance of the intravascular compartment is 
overwhelmed. 
=> New test assesses intravenous fluid. 
4 
Methods 
- Fluid overload examination: in the extravascular 
system and in the venous system. 
- The study group underwent the SEFV (Size and 
Expansibility of the Femoral Vein) test 
5 
SEFV test 
The first principle: the volume of blood going 
through the femoral artery and returning through 
the common femoral vein should be the same. 
6 
SEFV test 
The second principle: The veins have high 
compliance => can contain more blood while 
the arteries have high vascular tone => keep 
constant pressure. 
7 
8 
SEFV test 
Size of the femoral vein can change from the same 
size to the femoral artery or to be bigger. 
Estimate the amount of blood in the arteries and 
veins through ultrasound examination. 
SEFV is the ultrasound study examining the size of 
the femoral vein and its expansion with cough. 
9 
10 
Normal person at rest 
The size of the 
femoral vein is a 
little larger than the 
size of the common 
femoral artery 
11 
Normal person when cough 
The expansion of the femoral vein to less than 2 times 
larger than the baseline. 
12 
Abnormal person when cough 
Abnormal = dehydration or hypovolemia 
There is no minimal expansion of the femoral vein 
13 
Fluid overload in the veinous system 
14 
The study 
 Group A 
Patients diagnosed 
based on traditional 
method 
All patients also had beta natriuretic 
peptide (BNP) level measured 
 Group B 
Patients diagnosed 
with the new SEFV 
results 
15 
Enroll 
Divide into 2 groups 
SEFV/traditional method 
Collect data 
16 
Results 
50 patients with severe SOB were diagnosed with 
dilated cardiomyopathy with low ejection fraction 
(mean EF = 36%) 
17 
Results 
Diseases Percentage 
COPD 30% 
Chronic Kidney Disease 34% 
Liver Cirrhosis 4% 
18 
Results 
HF diagnosis Percentage 
BNP test 50% 
SEFV test 95% 
Clinical diagnosis 70% 
19 
Conclusions 
- The SEFV test was more accurate in confirming the 
diagnosis of acute decompensated heart failure than 
traditional diagnosis. 
- The diagnosis was based on the significant fluid 
overload in the venous system as evidenced by the 
SEFV test. 
20 
Thank you 
for your attention! 
21