一种用于测定左心室充盈压的非侵入性系统的评估。

Evaluation of a noninvasive system for determining left ventricular filling pressure.

作者信息

Sharma G V R K, Woods Patricia A, Lambrew Costas T, Berg Claire M, Pietro Daniel A, Rocco Thomas P, Welt Frederick W, Sacchetti Peter, McIntyre Kevin M

机构信息

Division of Cardiology, Medical Service, Veterans Affairs Healthcare System and Harvard Medical School, Boston, MA, USA.

出版信息

Arch Intern Med. 2002 Oct 14;162(18):2084-8. doi: 10.1001/archinte.162.18.2084.

DOI:10.1001/archinte.162.18.2084

PMID:12374516

Abstract

BACKGROUND

Measurement of left ventricular filling pressure (LVFP) provides an accurate assessment of left ventricular failure. Clinical and radiographic methods of estimating LVFP are unreliable. The noninvasive method of analyzing the decline in the arterial pressure during the strain phase of the Valsalva maneuver may be used to directly measure LVFP.

OBJECTIVE

To examine the relationship and the level of accuracy of a noninvasive system (VeriCor) in directly determining left ventricular end diastolic pressure (LVEDP) using simultaneously recorded VeriCor and LVEDP measurements obtained during left heart catheterization.

METHODS

During elective right and left heart catheterization, LVFP was assessed by measuring pulmonary capillary wedge pressure (PCWP) and LVEDP in 57 patients followed immediately by a Valsalva maneuver using the VeriCor assembly to estimate these pressures noninvasively.

RESULTS

VeriCor measurements had a significant correlation with the catheter-measured LVEDP (r = 0.86), comparable to the correlation of the catheter-measured PCWP with LVEDP (r = 0.81). The predictive accuracy of VeriCor for LVEDP, however, appeared to be superior to that of catheter-measured PCWP for LVEDP: 84% of VeriCor measurements compared with only 41% of PCWP measurements were within 4 mm Hg of catheter-measured LVEDP, and 93% of VeriCor measurements compared with only 67% of PCWP measurements were within 6 mm Hg of catheter-measured LVEDP.

CONCLUSION

VeriCor is a reliable noninvasive tool for measuring LVFP.

摘要

背景

左心室充盈压（LVFP）的测量可准确评估左心室衰竭。估计LVFP的临床和影像学方法并不可靠。在瓦尔萨尔瓦动作应变期分析动脉压下降的无创方法可用于直接测量LVFP。

目的

使用在左心导管插入术期间同时记录的VeriCor和左心室舒张末期压力（LVEDP）测量值，检验一种无创系统（VeriCor）在直接测定LVEDP方面的关系和准确性水平。

方法

在择期右心和左心导管插入术期间，对57例患者通过测量肺毛细血管楔压（PCWP）和LVEDP来评估LVFP，随后立即使用VeriCor组件进行瓦尔萨尔瓦动作以无创估计这些压力。

结果

VeriCor测量值与导管测量的LVEDP显著相关（r = 0.86），与导管测量的PCWP与LVEDP的相关性（r = 0.81）相当。然而，VeriCor对LVEDP的预测准确性似乎优于导管测量的PCWP对LVEDP的预测准确性：与导管测量的LVEDP相差4 mmHg以内时，VeriCor测量值的84%与PCWP测量值的仅41%相比；与导管测量的LVEDP相差6 mmHg以内时，VeriCor测量值的93%与PCWP测量值的仅67%相比。