Does non-invasive ventilatory support have an effect on endothelial function in a patient with decompensated heart failure? A quasi-experimental study.

• Grant number: 22/13556-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): November 01, 2022
• Effective date (End): October 31, 2023
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Renata Gonçalves Mendes
• Grantee: Bruna Maciel Melo
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Associated research grant: 15/26501-1 - Study of limiting factors to physical exercise and adjunct effects to rehabilitation on cardiorespiratory disease: a multicentre approach, AP.TEM

Abstract

Heart Failure (HF) is a complex clinic syndrome in which the heart does not adequately supply tissue needs and it is commonly accompanied by endothelial dysfunction. Non Invasive Ventilation (NIV) is the therapeutic approach indicated to HF patients during the decompensation period. Despite NIV effectiveness in endothelial function in other pathological profiles, there is still no knowledge about its effectiveness on endothelial function in HF patients. Objective: To investigate the impact of NIV on endothelial function in decompensated HF hospitalized patients. Methods: Prospective and longitudinal study that will include hospitalized adults (n=16), of both sex, with clinic diagnostic of decompensated HF and Ecodoppler identified left ventricular ejection fraction < 45% in decompensated fase. Personal information data, cognitive assessment and functional profile will be collected. NIV will be applied in Bilevel mode between 30 and 60 minutes, with the inspiratory pressure starting at 6 and gradually increasing to a maximum of 12 cmH2O, and the expiratory pressure starting at 4 cmH2O and gradually increasing to a maximum of 8 cmH2O according to patient comfort and tolerance. Endothelial function will be assessed using the flow-mediated dilation method verified by ultrasound in the pre- and immediately post-intervention moments. The data acquired may provide useful knowledge in the identification and the understanding of new benefits of VNI appliance, as well as to elucidate a putative beneficial response in the endothelial function of hospitalized patients for decompensated HF treatment.