title: A Novel Acquisition Technique to Utilize Swan-Ganz Catheter data as a Surrogate for High-fidelity Micromanometry within the Right Ventricle and Pulmonary Circuit.
abstract: We explored the possibility of using conventional right-heart catheterization data, gathered both prospectively and retrospectively, as a surrogate for high-fidelity micro-manometery when analyzing systolic and diastolic RV function and calculating various ventricular and pulmonary hemodynamic parameters in the time domain. Right heart catheterizations were performed on 13 patients (7 female), who were suspected of having pulmonary hypertension. The procedure included use of both fluid-filled catheter and high-fidelity micromanometry to measure right ventricular and pulmonary arterial pressures. A digital data acquisition system was used to record micromanometer readings and data from the fluid-filled catheter system during prospective portion of the study. Retrospective data was obtained by direct digitization of screen captures taken by the conventional clinical system (fluid-filled catheter). From the 13 patients, 12-13 RV waveforms and 12 PA waveforms were acquired from each method. Basic measurements of heart rate, systolic pressure, diastolic pressure,dP/dtmax, anddP/dtminwere compared between micromanometry, direct acquisition from the PA catheter (voltage acquisition), and re-digitization of the hemodynamic waveforms (tracing). Correlation between Swan and tracing was stronger than that of Millar and Swan. SBP, followed by HR, has the strongest correlation of any parameter for all three methods, while DBP appears to be the weakest. Bland-Altman analysis shows all parameters to have minimal biases that are within clinical limits. Interoperator and intraoperator variability was minimal. Digital right-heart catheterization (RHC) data can be used as a surrogate for micromanometric data under ideal conditions for hemodynamic measures in the time domain. Pre-existing RHC data can be re-digitized for more rigorous hemodynamic analysis.
authors.affiliation: Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: T N
authors.initials: TN
authors.lastname: Bachman
authors.affiliation: Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Bursic
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA ; Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA ; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA ; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Simon
authors.affiliation: Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA ; Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA ; Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA ; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA ; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA ; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 3459 Fifth Avenue, MUH S638, Pittsburgh, PA 15238, USA.
authors.forename: H C
authors.initials: HC
authors.lastname: Champion
keywords: Catheter; Hemodynamics; Pulmonary arterial pressure; Right heart catheterization; Right ventricular pressure