Hybrid logistic function characterization of left ventricular pressure-time curve in left heart catheterization

Author(s):  
Ju Mizuno ◽  
Mikiya Otsuji ◽  
Yoshihiro Fukuoka ◽  
Yasuhiro Tanaka ◽  
Mitsuru Ohishi ◽  
...  
2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H T Ozer ◽  
O Ozer ◽  
C Coteli ◽  
A Kivrak ◽  
M L Sahiner ◽  
...  

Abstract Background Diastolic dysfunction is an important factor in the development of heart failure with preserved ejection fraction (HFpEF). As the ejection fraction is preserved in HFpEF, the diagnosis of this disease with non-invasive methods is difficult. Purpose In this study, the relationship of BNP, NT-proBNP, Ghrelin, and echocardiographic 3D strain findings with diastolic dysfunction was investigated in patients undergoing left heart catheterization. Methods Our study is a cross-sectional study and included 78 patients in whom echocardiography was performed, and who underwent left heart catheterization based on relevant indications. The patient data recorded for evaluation included the findings from left heart catheterization, follow-up 3D echocardiography; and the levels of blood NT-proBNP, and Ghrelin. Results The rate of diastolic dysfunction was 42.3%. Longitudinal 2D and 3D mean strain as absolute values were observed to decrease more in patients with diastolic dysfunction. The median levels of BNP, NT-proBNP, and Ghrelin levels were higher in patients with diastolic dysfunction. The independent predictors of diastolic dysfunction were determined to be the left atrial volume index (LAVI) (OR=1.17; p=0.018), longitudinal 3D strain values (OR=1.88; p<0.001), NT-proBNP (OR=1.11; p=0.001), and Ghrelin (OR=1.40; p=0.001), respectively. Relationship Between LV EDP and LV Longitudinal Strain LV EDP 2D Strain 3D Strain r p r p r p BNP, pg/ml 0.429 <0.001* 0.115 0.316 0.178 0.118 NT-proBNP, pg/ml 0.484 <0.001* 0.155 0.177 0.186 0.104 Ghrelin, pg/ml 0.478 <0.001* 0.086 0.455 0.157 0.169 SolV DB – – 0.481 <0.001* 0.591 <0.001* dP/dT −0.389 <0.001* −0.283 0.012* −0.307 0.006* Negative dP/dT −0.747 <0.001* −0.337 0.003* −0.458 <0.001* 2D. % 0.481 <0.001* – – 0.852 <0.001* 3D. % 0.591 <0.001* 0.852 <0.001* – – If p value is less than 0.05 shows statistical significance. Measurement of longitudinal strain Conclusion In conclusion, our study found out that the reduced 3D strain absolute values and increased levels of NT-proBNP and Ghrelin biomarkers predicted diastolic dysfunction. If further large-scale studies prove the efficiency of these practical, they may not only allow for making a diagnosis of HFpEF more readily but may also eliminate the confusion in diagnostic algorithms. Acknowledgement/Funding None


PEDIATRICS ◽  
1962 ◽  
Vol 30 (2) ◽  
pp. 253-261
Author(s):  
Edwin C. Brockenbrough ◽  
Eugene Braunwald ◽  
John Ross ◽  
Andrew G. Morrow

Experiences with left heart pressure measurements in 111 infants and children are reviewed. These studies were performed by means of transseptal left heart catheterization or anterior percutaneous left ventricular puncture. The only significant complication was the development of left pneumothorax in two patients following the latter procedure. The techniques are briefly described, and the importance of left heart catheterization in the clinical management of infants and children with heart disease is illustrated by means of selected clinical examples.


2020 ◽  
Vol 10 (4) ◽  
pp. 204589402092915 ◽  
Author(s):  
Shelsey W. Johnson ◽  
Alison Witkin ◽  
Josanna Rodriguez-Lopez ◽  
Richard Channick

To describe the frequency with which pulmonary capillary wedge pressure measurements, obtained during right heart catheterization, are falsely elevated and to educate operators on techniques to improve accuracy of pulmonary capillary wedge pressure reporting. Failure to completely occlude pulmonary artery branch vessels during balloon inflation can lead to falsely elevated, “incomplete” pulmonary capillary wedge pressures. Balloon deflation prior to catheter retraction may result in catheter advancement into smaller branch vessels, yielding an inadvertent but more accurate alternative pulmonary capillary wedge pressure. We hypothesized that this phenomenon can be identified on retrospective review of right heart catheterization tracings, which occurs commonly and goes unrecognized by operators. We conducted a retrospective study of patients undergoing right heart catheterization or right heart catheterization and left heart catheterization with computer-generated pulmonary capillary wedge pressure ≥20 from January 2015 to June 2017. Alternative pulmonary capillary wedge pressures were defined as a pulmonary capillary wedge pressure trace during balloon deflation ≥3 mmHg lower than the reported pulmonary capillary wedge pressure. Inter-rater reliability of tracing reviewers was also evaluated. Results showed that, of the 182 tracings reviewed, an alternative pulmonary capillary wedge pressure was identified in 26 or 14.3% of cases. Eleven of these alternative pulmonary capillary wedge pressures were ≤15 mmHg with a calculated pulmonary vascular resistance ≥3 Wood units in 10 patients, re-classifying the etiology of pulmonary hypertension from post-capillary to pre-capillary in 38.5% of cases. For the eight patients for whom left heart catheterization data were available, left ventricular end-diastolic pressure aligned with the alternative pulmonary capillary wedge pressure. In conclusion, inadvertently obtained, but likely more accurate, alternative pulmonary capillary wedge pressures were identified in almost 15% of procedures reviewed from a busy academic institution. As wedge pressures often drive diagnosis and treatment decisions for patients with cardiac and pulmonary pathology, operators should be attuned to balloon deflation as a time when alternative pulmonary capillary wedge pressures may be identified as they are likely more reflective of left ventricular end-diastolic pressure. Additional tools to ensure accuracy of pulmonary capillary wedge pressure reporting are reviewed.


1995 ◽  
Vol 45 (3) ◽  
pp. 535-552 ◽  
Author(s):  
Hiromi MATSUBARA ◽  
Junichi ARAKI ◽  
Miyako TAKAKI ◽  
Sachiko T. NAKAGAWA ◽  
Hiroyuki SUGA

2019 ◽  
Vol 8 ◽  
pp. 204800401985680
Author(s):  
Ethan D Hinds ◽  
Manuel J Marin ◽  
Joggy George ◽  
Reynolds Delgado

A 56-year-old man who had twice previously undergone orthotopic heart transplantation was admitted with dyspnea and heart failure symptoms. A biopsy excluded rejection. Left heart catheterization revealed a coronary cameral fistula. After the patient was given mild diuretics, his condition improved. No significant fistula flow was detected, and he was discharged. Several months later, the patient was readmitted with worsening chest pain and dyspnea. Left ventricular end-diastolic pressure and flow through the fistula were increased. To correct the coronary cameral fistula, we performed a coil embolization without complications. Several months later at follow-up, the patient’s symptoms had resolved, and his left ventricular end-diastolic pressure had normalized. We conclude that coronary fistulas may be caused by trauma to the heart during the de-airing process, which may be prevented in the future with the development of safer and more effective de-airing techniques.


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