Using repeated measures of blood biomarkers and physical biomeasures to define changes in volume status in patients with decompensated heart failure, normal volunteers and patients with stable left ventricular systolic dysfunction

Ng Kam Chuen, Marie Jennyfer (2012). Using repeated measures of blood biomarkers and physical biomeasures to define changes in volume status in patients with decompensated heart failure, normal volunteers and patients with stable left ventricular systolic dysfunction. University of Birmingham. M.D.

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Abstract

Background
The non-invasive assessment of volume status in left ventricular systolic dysfunction (LVSD) is challenging. The main thesis objective was to establish the feasibility and potential clinical utility of repeated measures assessment of non-invasive biomarkers in defining changes in volume status within individual volunteers.
Methods
Differential volume manipulation protocols were achieved in a three-staged plan of investigation[…]
Results Summary
I demonstrated the smallest variance for bioimpedance measures, and the largest variance for urine biomarkers […]
Conclusion
The repeated measures of biomarkers studied in response to different volume manipulations were interpreted in the context of their within-subject normal variance. None of the biomarkers studied appeared to have the ideal characteristics clinically for the monitoring of subclinical changes in volume status in stable LVSD or in response to acute diuresis in decompensated heart failure. The significant increases in urine biomarkers following diuretic withdrawal in stable LVSD suggested potentially beneficial renal effects of furosemide in
stable LVSD.

Type of Work:

Thesis (Higher Doctorates > M.D.)

Award Type:

Higher Doctorates > M.D.

Supervisor(s):