HVAD Flow Waveform Estimates Left Ventricular Filling Pressure.
HVAD Flow Waveform Estimates Left Ventricular Filling Pressure.
- 2020
Available online from MWHC library: 1995 - present
BACKGROUND: HVAD left ventricular assist device (LVAD) flow waveforms provides graphical real-time information linking device performance with invasive hemodynamics. Previous studies have demonstrated a good correlation between the slopes of the ventricular filling phase (VFPS) and directly measured pulmonary capillary wedge pressure (PCWP). We aimed to validate the utility of VFPS to estimate PCWP and predict clinical outcomes. CONCLUSIONS: VFPS of the HVAD flow waveform is a novel noninvasive parameter that can estimate PCWP. Copyright (c) 2020 Elsevier Inc. All rights reserved. METHODS: In this prospective blinded study, screenshots from the HVAD monitor and simultaneous invasive hemodynamic measurements were obtained. Each screenshot was digitized and the VFPS was calculated by two independent readers who were blinded to the hemodynamic results. The equation PCWP=7.053 +1.365x(VFPS) was derived from a previously published data set and the estimated PCWP was correlated to the actually measured PCWP. RESULTS: 131 sets of simultaneous measurements (VFPS and PCWP) were obtained from 27 HVAD patients (mean age 55 years, 47% male). A previously proposed cutoff of VFPS >=5.8 L/min/sec predicted PCWP >=18 mmHg with 91.5% sensitivity and 95.2% specificity with the area under curve of 0.987. The estimated PCWP significantly correlated with measured PCWP (R2=0.65, p <0.001) and showed acceptable agreement with measured PCWP. Patients with VFPS >=5.8 L/min/sec experienced significantly higher heart failure readmission rates than those without (0.24 vs. 0.05 events/year, p <0.001).
English
1071-9164
10.1016/j.cardfail.2020.01.012 [doi] S1071-9164(19)31407-1 [pii]
*Heart Failure
*Heart-Assist Devices
Female
Heart Failure/di [Diagnosis]
Heart Ventricles/dg [Diagnostic Imaging]
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Wedge Pressure
MedStar Heart & Vascular Institute
Journal Article
Available online from MWHC library: 1995 - present
BACKGROUND: HVAD left ventricular assist device (LVAD) flow waveforms provides graphical real-time information linking device performance with invasive hemodynamics. Previous studies have demonstrated a good correlation between the slopes of the ventricular filling phase (VFPS) and directly measured pulmonary capillary wedge pressure (PCWP). We aimed to validate the utility of VFPS to estimate PCWP and predict clinical outcomes. CONCLUSIONS: VFPS of the HVAD flow waveform is a novel noninvasive parameter that can estimate PCWP. Copyright (c) 2020 Elsevier Inc. All rights reserved. METHODS: In this prospective blinded study, screenshots from the HVAD monitor and simultaneous invasive hemodynamic measurements were obtained. Each screenshot was digitized and the VFPS was calculated by two independent readers who were blinded to the hemodynamic results. The equation PCWP=7.053 +1.365x(VFPS) was derived from a previously published data set and the estimated PCWP was correlated to the actually measured PCWP. RESULTS: 131 sets of simultaneous measurements (VFPS and PCWP) were obtained from 27 HVAD patients (mean age 55 years, 47% male). A previously proposed cutoff of VFPS >=5.8 L/min/sec predicted PCWP >=18 mmHg with 91.5% sensitivity and 95.2% specificity with the area under curve of 0.987. The estimated PCWP significantly correlated with measured PCWP (R2=0.65, p <0.001) and showed acceptable agreement with measured PCWP. Patients with VFPS >=5.8 L/min/sec experienced significantly higher heart failure readmission rates than those without (0.24 vs. 0.05 events/year, p <0.001).
English
1071-9164
10.1016/j.cardfail.2020.01.012 [doi] S1071-9164(19)31407-1 [pii]
*Heart Failure
*Heart-Assist Devices
Female
Heart Failure/di [Diagnosis]
Heart Ventricles/dg [Diagnostic Imaging]
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Wedge Pressure
MedStar Heart & Vascular Institute
Journal Article