Second Department of Medicine, University of Toyama, Japan.
Advocate Christ Medical Center, USA.
Intern Med. 2021 Jan 15;60(2):167-171. doi: 10.2169/internalmedicine.4615-20. Epub 2020 Jun 2.
Abnormal hemodynamics are associated with poor clinical outcomes in patients with heart failure. Given the invasiveness and unfeasibility of routine right heart catheterization, non-invasive methodologies to monitor hemodynamics are needed. The CardioMEMS™ device is a recently developed technology that enables remote monitoring of pulmonary artery pressures via an implanted sensor located in the distal left pulmonary artery. Along with the CardioMEMS™, a remote dielectric system might be another promising device that reports indirect intra-thoracic filling pressures associated with pulmonary congestion. In patients with advanced heart failure who require left ventricular assist devices, non-invasive hemodynamic monitoring is particularly necessary, given the increased procedural risks of invasive assessments. The HeartWare ventricular assist device flow waveform is a variable under active investigation that might also provide an estimation of filling pressures. This methodology is expected to lead to the development of a smart pump that can adjust its own settings, including the pump speed, automatically by monitoring the hemodynamics.
异常的血液动力学与心力衰竭患者的临床预后不良有关。鉴于常规右心导管术的侵入性和不可行性，需要非侵入性的血液动力学监测方法。CardioMEMS™ 装置是一种最近开发的技术，通过位于左肺远端的植入式传感器可实现肺动脉压力的远程监测。除了 CardioMEMS™ 之外，远程介电系统可能是另一种有前途的设备，它可以报告与肺充血相关的间接胸腔内充盈压。对于需要左心室辅助装置的晚期心力衰竭患者，由于侵入性评估的程序风险增加，非侵入性血液动力学监测尤为必要。HeartWare 心室辅助装置流量波形是一个正在积极研究的变量，它也可能提供对充盈压的估计。这种方法有望开发出一种智能泵，通过监测血液动力学，智能泵可以自动调整自身的设置，包括泵速。
