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Accuracy of Doppler blood pressure measurement in continuous-flow left ventricular assist device patients

Song Li1, Jennifer A Beckman1, Nathan G Welch2

  • 1Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, 98195, USA.

ESC Heart Failure
|May 18, 2019
PubMed

Insights

Accurate blood pressure (BP) measurement is crucial for continuous-flow ventricular assist device (CF-VAD) patients. Doppler opening pressure offers a reliable non-invasive method for BP assessment in these individuals.

Area of Science:

  • Cardiovascular Medicine
  • Biomedical Engineering

Background:

  • Accurate blood pressure (BP) monitoring is critical for managing patients with continuous-flow ventricular assist devices (CF-VADs) to mitigate risks such as stroke.
  • Current non-invasive BP measurement methods may lack accuracy in CF-VAD populations.

Purpose of the Study:

  • To evaluate the accuracy of the Doppler opening pressure method for BP measurement in CF-VAD patients.
  • To compare Doppler opening pressure accuracy against the gold standard invasive arterial line method.

Main Methods:

  • A longitudinal cohort study involving HeartMate II and HVAD patients.
  • Simultaneous measurement of arterial line BP and Doppler opening pressure.
  • Analysis of correlation and agreement between methods, including the impact of arterial pulsatility.

Main Results:

  • 1933 paired readings from 154 CF-VAD patients were analyzed.
  • Doppler opening pressure showed good correlation with invasive mean arterial pressure (r=0.742, P<0.0001).
  • The method more accurately approximated mean arterial pressure (mean error 2.4 mmHg) than systolic BP (mean error -8.4 mmHg), with no significant effect from arterial pulsatility.

Conclusions:

  • Doppler opening pressure demonstrates good accuracy for BP measurement in CF-VAD patients.
  • This non-invasive technique is a viable alternative to invasive monitoring.
  • Doppler opening pressure is recommended as the standard non-invasive BP measurement in CF-VAD patients.
Abstract

Keywords:
Blood pressureHaemodynamicsHeart failure

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