Hemodynamic monitoring in heart failure and pulmonary hypertension: From analog tracings to the digital age.
Hemodynamic monitoring has long formed the cornerstone of heart failure (HF) and pulmonary hypertension diagnosis and management. We review the long history of invasive hemodynamic monitors initially using pulmonary artery (PA) pressure catheters in the hospital setting, to evaluating the utility of a number of implantable devices that can allow for ambulatory determination of intracardiac pressures. Although the use of indwelling PA catheters has fallen out of favor in a number of settings, implantable devices have afforded clinicians an opportunity for objective determination of a patient's volume status and pulmonary pressures. Some devices, such as the CardioMEMS and thoracic impedance monitors present as part of implantable cardiac defibrillators, are supported by a body of evidence which show the potential to reduce HF related morbidity and have received regulatory approval, whereas other devices have failed to show benefit and, in some cases, harm. Clearly these devices can convey a considerable amount of information and clinicians should start to familiarize themselves with their use and expect further development and refinement in the future.
Ryan Davey, Amresh Raina, Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, PA 15212-4772, United States.
Ryan
R
Davey
Ryan Davey, Amresh Raina, Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, PA 15212-4772, United States.
Amresh
A
Raina
Heart failure; Hemodynamic monitoring; Left ventricular assist device; Outcomes; Pulmonary hypertension; Right heart catheterization; Transplant
Int J Cardiol. 2005 Jun 8;101(3):415-20
15907409
Circulation. 2009 Jan 6;119(1):147-52
19124674
Circulation. 2012 Jul 24;126(4):501-6
22825412
Circ Heart Fail. 2010 Jan;3(1):97-103
19903931
Circulation. 2010 Mar 9;121(9):1086-95
20176990
Lancet. 2011 Feb 19;377(9766):658-66
21315441
JAMA. 2005 Oct 5;294(13):1625-33
16204662
Am J Respir Crit Care Med. 2014 Aug 1;190(3):252-7
24869464
Am Heart J. 2009 Mar;157(3):402-11
19249408
Congest Heart Fail. 2011 Mar-Apr;17(2):51-5
21449992
Pacing Clin Electrophysiol. 2005 Aug;28(8):747-53
16104999
J Am Coll Cardiol. 2008 Mar 18;51(11):1073-9
18342224
Clin Chest Med. 2007 Mar;28(1):23-42, vii
17338926
Pacing Clin Electrophysiol. 2013 May;36(5):570-7
23448187
Lancet. 2016 Jan 30;387(10017):453-61
26560249
Chest. 2003 Jul;124(1):351-9
12853544
Circulation. 1984 Oct;70(4):580-7
6148159
Nat Rev Cardiol. 2011 Jan;8(1):30-41
21060326
J Am Coll Cardiol. 2006 Dec 19;48(12):2546-52
17174196
J Card Fail. 2014 Jul;20(7):485-91
24816520
Eur Respir J. 2007 Jul;30(1):104-9
17360728
Cardiol Res Pract. 2013;2013:130724
24251065