(423) Decoupling of Hemodynamics and Congestive Symptoms in Obese Heart Failure Patients

Purpose:BackgroundPrior studies indicate significant physiologic differences between obese and non-obese heart failure (HF) patients, but none have evaluated in hemodynamic patterns these patient populations during treatment for acute decompensated HF (ADHF). ObjectivesIn this study, we assessed trends patients ADHF.MethodsObese (BMI >30, n=63) <25, n=69) with ADHF the Evaluation Study of Congestive Heart Failure Pulmonary Artery Catheterization Effectiveness (ESCAPE) study who had pulmonary artery catheterization data available through duration were evaluated. Hemodynamics analyzed at baseline optimal day. Changes BNP, weight, creatinine, BUN, 6MWT, orthopnea dyspnea scores assessed.ResultsDespite similar hemodynamics, significantly less absolute relative arterial wedge pressure (PAWP) reduction (-16 ± 28 versus -32 29%, p = 0.04) treatment. Obese also higher PAWP (22.1 + 8 14.9 7.4 mmHg, p=0.001) PA pressures optimization compared patients. improvements six minute walk test distance, scores, changes creatinine BUN.ConclusionObese treated display invasively measured left filling pressures, despite symptoms, weight loss, noninvasive surrogates congestion (Figure). Our findings suggest a degree decoupling congestive symptoms :BackgroundPrior ADHF. assessed. Despite BUN.