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Thermal vasodilation by portable device for decompensated heart failure management


Thermal vasodilation using sauna bathing has been demonstrated haemodynamic useful in heart failure. However, in decompensated phase with intravenous inotropic support, patients are restricted at bed; consequently thermal vasodilation by sauna bathing is not appropriated. We propose study haemodynamic effects of heating by portable thermal blanket in decompensated severe heart failure. We will study patients with severe heart failure hospitalized by decompensation, LVEF < 40%, in use of intravenous inotropic support at last 5 days and one or more oral drugs like captopril, losartan or hidralazine. Patients will be randomized in 2 groups (T and C). Group T will be submitted to thermal vasodilation therapy by infrared blanket to achieve 50°C of extra-corporal temperature for 4 days. Haemodynamic measures, by thermodilution method, will be done at baseline and 40 minutes after at first and fourth days. At second and third days, a non-invasive method will be used to haemodynamic measures (Finometer monitor, Finapres Medical Systems). ANOVA by repeated measures will be used with p < 0.05. On basis in a pilot study, we estimate cardiac index increases 47.8% and systemic vascular resistance decreases 26.3%, with thermal vasodilation by portable device. To p < 0.05 and power 80%, we calculated a sample size with 64 patients. Primary endpoint is reduction of systemic vascular resistence. (AU)

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