Effectiveness of corrected carotid flow time and inferior vena cava collapsibility index in diagnosis and treatment of patients presenting to emergency department with heart failure signs

Purpose: Aim of this study is the comparison of vena cava inferior collapsibility index(VCCI) and corrected carotis flow time (FTc) for assement of volume status and treatment response of patients who admitted to emergency department wih congestive heart failure(HF).Data acquiered from this study may provide the use of a new more applicable method for diagnosis and treatment of heart failiure patients. Material and Methods: this study was designed as a prospective, observational, analytical study. 125 patients who were admitted to the Emergency Department of Ege University between September 2018 and February 2019 with the preliminary diagnosis of Decompansated Heart Failure were included in the study with the permission of Ege University Non-Interventional Research Ethics Committee. Patient's age, sex, complaints to the emergency department, comorbid diseases, cardiac medications and vitals were recorded.Physical examination (Rales, PTE, JVD) and inferior vena cava (IVC) diameter , IVCCI, carotis flow rate , lung and cardiac ultrasonography evaluated by bedside ultrasonography by the emergency physician. . Afterwards, the patients were not intervened in the process of diagnosis, examination and treatment in emergency department. In patients who were treated in the emergency department, IVC diameters, IVCCI and carotid flow were reevaluated and recorded by USG. Statistical analyzes were performed according to the recorded data. Findings : In heart failiure patients ,relationship between Corrected carotis flow time and classified Ejection fractions were analysed. There was a statistically significant relationship between the group with EF value below 40 and the group between 40-50 (p = 0.01).However this relationship did not observed with other groups. In patients with HF, both IVCCI and IVC diameters were correlated with right and left ventricle EF. When the patients were grouped according to EF, there was a significant difference between the group below 40% EF and the group above %40 EF . IVCCI changed more effectively in the group above 40% EF. There was a negative correlation between change in IVCCI and change in FTc (%). But this was not statistically significant (Rho = -0.027). Conclusion: Bedside USG is effective in the diagnosis and follow-up of HF patients admitted to the emergency department. IVCCI can be used in the diagnosis and treatment of heart failure patients. IVCCI is a more useful method for patients with EF above 40%. FTc is not suitable for ithe diagnosis and treatment of HF patients because of multiple interactions.