A Novel Acquisition Technique to Utilize Swan-Ganz Catheter data as a Surrogate for High-fidelity Micromanometry within the Right Ventricle and Pulmonary Circuit

被引：12
作者：
Bachman T.N. [1 ]
Bursic J.J. [1 ]
Simon M.A. [2 ,3 ,4 ,5 ]
Champion H.C. [1 ,2 ,3 ,4 ,5 ,6 ]
机构：
[1] Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA
[2] Department of Medicine, University of Pittsburgh, Pittsburgh, PA
[3] Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA
[4] Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
[5] Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA
[6] Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15238, 3459 Fifth Avenue
来源：
Cardiovascular Engineering and Technology | 2013年 / 4卷 / 02期
关键词：
Catheter; Hemodynamics; Pulmonary arterial pressure; Right heart catheterization; Right ventricular pressure;
D O I：
10.1007/s13239-013-0124-z
中图分类号：
学科分类号：
摘要：
We explored the possibility of using conventional right-heart catheterization data, gathered both prospectively and retrospectively, as a surrogate for high-fidelity micromanometery 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, and dP/dtmin were 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. © 2013 Biomedical Engineering Society.
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页码：183 / 191
页数：8
相关论文
共 6 条
  • [1] Champion H.C., Michelakis E.D., Hassoun P.M., Comprehensive invasive and noninvasive approach to the right ventricle-pulmonary circulation unit: state of the art and clinical and research implications, Circulation, 120, 11, pp. 992-1007, (2009)
  • [2] Falsetti H.L., Et al., Analysis and correction of pressure wave distortion in fluid-filled catheter systems, Circulation, 49, 1, pp. 165-172, (1974)
  • [3] Gould K.L., Trenholme S., Kennedy J.W., In vivo comparison of catheter manometer systems with the catheter-tip micromanometer, J. Appl. Physiol., 34, 2, pp. 263-267, (1973)
  • [4] Hemnes A.R., Forfia P.R., Champion H.C., Assessment of pulmonary vasculature and right heart by invasive haemodynamics and echocardiography, Int. J. Clin. Pract. Suppl., 162, pp. 4-19, (2009)
  • [5] Nichols W.W., Et al., Percutaneous left ventricular catheterisation with an ultraminiature catheter-tip pressure transducer, Cardiovasc. Res., 12, 9, pp. 566-568, (1978)
  • [6] Ryan J.J., Et al., Current practice for determining pulmonary capillary wedge pressure predisposes to serious errors in the classification of patients with pulmonary hypertension, Am. Heart J., 163, 4, pp. 589-594, (2012)
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