Evaluation of a noninvasive system for determining left ventricular filling pressure.
BACKGROUND
Measurement of left ventricular filling pressure (LVFP) provides an accurate assessment of left ventricular failure. Clinical and radiographic methods of estimating LVFP are unreliable. The noninvasive method of analyzing the decline in the arterial pressure during the strain phase of the Valsalva maneuver may be used to directly measure LVFP.


OBJECTIVE
To examine the relationship and the level of accuracy of a noninvasive system (VeriCor) in directly determining left ventricular end diastolic pressure (LVEDP) using simultaneously recorded VeriCor and LVEDP measurements obtained during left heart catheterization.


METHODS
During elective right and left heart catheterization, LVFP was assessed by measuring pulmonary capillary wedge pressure (PCWP) and LVEDP in 57 patients followed immediately by a Valsalva maneuver using the VeriCor assembly to estimate these pressures noninvasively.


RESULTS
VeriCor measurements had a significant correlation with the catheter-measured LVEDP (r = 0.86), comparable to the correlation of the catheter-measured PCWP with LVEDP (r = 0.81). The predictive accuracy of VeriCor for LVEDP, however, appeared to be superior to that of catheter-measured PCWP for LVEDP: 84% of VeriCor measurements compared with only 41% of PCWP measurements were within 4 mm Hg of catheter-measured LVEDP, and 93% of VeriCor measurements compared with only 67% of PCWP measurements were within 6 mm Hg of catheter-measured LVEDP.


CONCLUSIONS
VeriCor is a reliable noninvasive tool for measuring LVFP.
Sharma
G V R K
GV
Division of Cardiology, Medical Service, Veterans Affairs Healthcare System and Harvard Medical School, Boston, MA, USA. gvrk_sharma@hotmail.com
Woods
Patricia A
PA
Lambrew
Costas T
CT
Berg
Claire M
CM
Pietro
Daniel A
DA
Rocco
Thomas P
TP
Welt
Frederick W
FW
Sacchetti
Peter
P
McIntyre
Kevin M
KM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D002138:Calibration; D006328:Cardiac Catheterization / Q000379:methods; D003327:Coronary Disease / Q000503:physiopathology* / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000601:surgery; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011669:Pulmonary Wedge Pressure; D012680:Sensitivity and Specificity; D014636:Valsalva Maneuver; D016277:Ventricular Function, Left; D017725:Ventricular Pressure