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Published on: November 26, 2018
Comparison of invasive and non-invasive measurements of haemodynamic parameters in patients with advanced heart
Mateusz Sokolski1, Agnieszka Rydlewska, Bartosz Krakowiak
1Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland. matsok@gmail.com
Insights
A non-invasive method for measuring hemodynamic parameters like stroke volume, cardiac output, and systemic vascular resistance shows adequate concordance with the invasive Swan-Ganz catheter in advanced heart failure patients.
Area of Science:
- Cardiology
- Medical Devices
- Hemodynamics
Background:
- Hemodynamic monitoring is crucial for advanced heart failure management.
- Invasive methods like Swan-Ganz catheters have limitations due to their invasiveness.
- Non-invasive alternatives are sought to improve patient care and monitoring accessibility.
Purpose of the Study:
- To assess the agreement between invasive (Swan-Ganz catheter) and non-invasive hemodynamic measurements.
- To evaluate the clinical applicability of a novel non-invasive device for hemodynamic monitoring in advanced heart failure.
- To determine the concordance of stroke volume, cardiac output, and systemic vascular resistance measurements using both methods.
Main Methods:
- Simultaneous measurement of resting hemodynamic parameters in 25 advanced heart failure patients.
- Comparison between invasive Swan-Ganz catheterization and a non-invasive finger arterial pressure waveform analysis device.
- Assessment of concordance using the Bland-Altman method and calculation of variability coefficients for stroke volume, cardiac output, and systemic vascular resistance.
Main Results:
- Variability coefficients were 13% for stroke volume, 18% for systemic vascular resistance, and 11% for cardiac output.
- Adequate concordance was observed between invasive and non-invasive measurements across various patient subgroups.
- The non-invasive method demonstrated consistent results regardless of decompensation status or atrial fibrillation.
Conclusions:
- Non-invasive hemodynamic monitoring using a pressure pulse contour model shows sufficient agreement with invasive methods.
- This non-invasive approach holds promise for routine clinical application in advanced heart failure patients.
- The findings support the potential of non-invasive techniques to enhance hemodynamic monitoring in this population.
Aim:
Measurement of haemodynamic parameters using a Swan-Ganz catheter is of clinical importance in patients with advanced heart failure; however, its applicability is limited due to its invasiveness. The aim of the study was to estimate the concordance between invasive and non-invasive measurements of haemodynamic parameters in patients with advanced heart failure.
Methods And Results:
We examined 25 patients with advanced heart failure (20 men, age: 64 ± 11 years, New York Heart Association class III/IV: 88/12%, left ventricular ejection fraction: 37 ± 20%), 13 (52%) demonstrated decompensated heart failure. Resting haemodynamic parameters were measured simultaneously using two methods: an invasive Swan-Ganz catheterization and a thermodilution technique; and a non-invasive recording using a device for finger arterial pressure waveform analysis. The following parameters were analysed: stroke volume (SV, ml), cardiac output (CO, l/min) and systemic vascular resistance (SVR, dyne × s/cm⁵). The concordance between these two methods was assessed using the variability coefficient calculated according to a Bland-Altman method. Comparing the invasive and non-invasive measures, variability coefficients were: 13, 18 and 11% for SV, SVR and CO, respectively. Similar variability coefficients were obtained when invasive and non-invasive measurements were compared in prespecified subgroups of patients, distinguished based on the presence of decompensation, atrial fibrillation and values of SBP.
Conclusions:
Evaluation of haemodynamic parameters using a non-invasive method based on a pressure pulse contour model reveals an adequate concordance with the measures obtained using an invasive approach. Our results suggest that a non-invasive method for haemodynamic monitoring could be applied in clinical practice in patients with advanced heart failure.
