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Serial echocardiographic changes with different body positions and sleeping side preference in heart failure patients
Author(s) -
Bayraktar Muhammed Fatih,
Ozeke Ozcan
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13888
Subject(s) - medicine , supine position , cardiology , position (finance) , hemodynamics , ventricular outflow tract , body position , heart failure , physical medicine and rehabilitation , finance , economics
Background The sleeping position plays an important role in overall health in both healthy individuals and heart failure ( HF ) patients, which complain of increasing dyspnea when adopting left lateral decubitus position ( LLDP ) that improves when turning over to the right lateral decubitus position ( RLDP ). Several theories have been proposed to explain this preference of HF patients; however, the underlying mechanisms remain unclear. Method We evaluated consecutive dilated cardiomyopathy ( DCMP ) patients with regard to whether they had a sleeping position preference and analyzed early and late left ventricular filling velocities, tissue Doppler recordings, tricuspid annular plane systolic excursion ( TAPSE ), and left ventricular outflow tract time‐velocity integral ( LVOT ‐ TVI ). Baseline echocardiographic parameters were obtained first by LLDP , followed by the supine position ( SP ) and finally RLDP in each position for 10 minutes to ensure a stabilized hemodynamic milieu. Results A total of 26 DCMP patients were included in this study and a 78 echocardiographic examination performed. We detected that many HF patients preferred the right lateral decubitus sleeping position ( RLDSP , 54%) and avoided from the left lateral decubitus sleeping position ( LLDSP , 40%); the echocardiographic LVOT TVI and TAPSE parameters were statistically higher in RLDP compared to SP and LLDP . Conclusion The echocardiographic LVOT TVI and TAPSE values as functional parameters of left and right ventricular function change with body position, and these hemodynamic changes may explain why HF patients willingly adopt RLDSP .