Peripheral Venous Oxygen Saturation and Biomarkers to Estimate Cardiac Output and Filling Pressures in Heart Failure

Study Overview
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Brief Summary
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The relationship between peripheral venous saturation and central hemodynamics (including right and left heart filling pressures and cardiac output), mixed venous oxygen saturation, and contemporary biomarkers of heart failure is not clear. We aim to determine the relationship between mixed venous, central venous, and peripheral venous oxygen saturation in patients with advanced (class III or IV) heart failure. We will determine the relationship between cardiac output measured via thermodilution and the Fick equation calculated using concurrent oxygen saturations from the distal PA, central vein, and peripheral vein. We also aim to examine the relationship of selected cardiac biomarkers with cardiac filling pressures and cardiac output over time in patients with decompensated heart failure.

Official Title
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Use of Peripheral Venous Oxygen Saturation and Biomarkers to Estimate Cardiac Output and Filling Pressures in Patients With Advanced Heart Failure

Conditions
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Congestive Heart Failure

Intervention / Treatment
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* Other: Standard of care therapy for severe decompensated heart failure


Participation Criteria
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Eligibility Criteria
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The following inclusion criteria will be utilized: Age>21 PA-catheter insertion for therapy of congestive heart failure decided upon by the attending cardiologist The following will be considered as exclusion criteria for this study Known or suspected septic shock or bacteremia Active bleeding or HCT<24% at baseline Arterial oxygen saturation <90% at baseline despite supplemental oxygen therapy. Previous difficulty with venipuncture of upper extremity veins or the presence of a surgical arteriovenous fistula for hemodialysis Insertion of the PA catheter through the femoral vein Subjects unwilling or unable to provide written consent

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Heart Failure Patients<br>Patients admitted with advanced heart failure for tailoring of heart failure therapy via placement of a pulmonary artery (PA) catheter. In our study, the patients will already have a PA catheter placed for clinical/treatment reasons when we approach them for the study. | Other: Standard of care therapy for severe decompensated heart failure<br>* Standard of care therapy for severe decompensated heart failure<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To determine the relationship between mixed venous, central venous, and peripheral venous oxygen saturation in patients with advanced (class III or IV) heart failure. |  | Day 0-5 of 'tailored' heart failure therapy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To examine the relationship of selected cardiac biomarkers with cardiac filling pressures and cardiac output over time in patients with decompensated heart failure. |  | Days 0-5 of 'tailored' heart failure therapy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Congestive heart failure, Cardiac biomarkers, Hemodynamics, Tailored therapy