Ambulatory hemodynamic monitoring from an implanted device: components of continuous 24-hour pressures that correlate to supine resting conditions and acute right heart catheterization.
Information from an implantable hemodynamic monitoring system (IHM) aids in management of patients with heart failure. This study identified which components of 24-hour IHM data best estimate resting conditions. Thirty-two patients with heart failure received an IHM in the right ventricular (RV) outflow tract. RV hemodynamics were divided into seven components of a 24-hour recording and were compared with resting supine values. Ambulatory pressures approximating rest were then compared with acute invasive catheterization values. Resting RV pressures from the IHM averaged 41+/-16/10+/-6 mm Hg and estimated pulmonary artery diastolic pressure was 21+/-8 mm Hg. Nighttime (midnight to 4 a.m.) minimum pressures from the IHM best approximated supine resting conditions. RV and pulmonary artery pressures during catheterization were higher than the nighttime minimum, although RV diastolic pressure was not statistically different. Minimum RV and pulmonary artery pressures during nighttime approximate observed resting conditions; invasive catheterization pressures are higher than IHM resting values.
Adamson
Philip B
PB
Heart Failure Institute at the Oklahoma Heart Hospital, 4050 West Memorial Road, 3rd Floor, Oklahoma City, OK 73120, USA. padamson@ocaheart.com
Kjellström
Barbro
B
Braunschweig
Frieder
F
Magalski
Anthony
A
Linde
Cecilia
C
Kolodiezj
Alan
A
Cremers
Bodo
B
Bennett
Tom
T
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods*; D012146:Rest; D016683:Supine Position; D013997:Time Factors