Khedraki Rola, Abraham Jacob, Jonsson Orvar, Bhatt Kunjan, Omar Hesham R, Bennett Mosi, Bhimaraj Arvind, Guha Ashrith, McCann Patrick, Muse Evan D, Robinson Monique, Sauer Andrew J, Cheng Andrew, Bagsic Samantha, Fudim Marat, Heywood J Thomas, Guglin Maya
Division of Cardiovascular Medicine, Scripps Clinic, Prebys Cardiovascular Institute, La Jolla, CA, United States.
Center for Cardiovascular Analytics, Research and Data Science, Providence Heart Institute, Providence Research Network, Portland, OR, United States.
Front Cardiovasc Med. 2023 Mar 2;10:1077365. doi: 10.3389/fcvm.2023.1077365. eCollection 2023.
In this multicenter prospective study, we explored the relationship between pulmonary artery pressure (PAP) at rest and in response to a 6-min walk test (6MWT) in ambulatory patients with heart failure (HF) with an implantable PAP sensor (CardioMEMS, Abbott).
Between 5/2019 and 2/2021, HF patients with a CardioMEMS sensor were recruited from seven sites. PAP was recorded in the supine and seated position at rest and in the seated position immediately post-exercise.
In our cohort of 66 patients, mean age was 70 ± 12 years, 67% male, left ventricular ejection fraction (LVEF) < 50% in 53%, mean 6MWT distance was 277 ± 95 meters. Resting seated PAPs were 31 ± 15 mmHg (systolic), 13 ± 8 mmHg (diastolic), and 20 ± 11 mmHg (mean). The pressures were lower in the seated rather than the supine position. After 6MWT, the pressures increased to PAP systolic 37 ± 19 mmHg ( < 0.0001), diastolic 15 ± 10 mmHg ( = 0.006), and mean 24 ± 13 mmHg ( < 0.0001). Patients with elevated PAP diastolic at rest (>15 mmHg) demonstrated a greater increase in post-exercise PAP.
The measurement of PAP with CardioMEMS is feasible immediately post-exercise. Despite being well-managed, patients had severely limited functional capacity. We observed a significant increase in PAP with ambulation which was greater in patients with higher baseline pressures.
在这项多中心前瞻性研究中，我们使用可植入肺动脉压力（PAP）传感器（CardioMEMS，雅培公司），探讨了门诊心力衰竭（HF）患者静息状态下及6分钟步行试验（6MWT）期间肺动脉压力（PAP）之间的关系。
在2019年5月至2021年2月期间，从7个地点招募了植入CardioMEMS传感器的HF患者。记录静息状态下仰卧位和坐位以及运动后即刻坐位的PAP。
在我们的66例患者队列中，平均年龄为70±12岁，男性占67%，53%的患者左心室射血分数（LVEF）<50%，平均6MWT距离为277±95米。静息坐位时的PAP分别为收缩压31±15 mmHg、舒张压13±8 mmHg、平均压20±11 mmHg。坐位时的压力低于仰卧位。6MWT后，压力升高至收缩压PAP 37±19 mmHg（<0.0001）、舒张压15±10 mmHg（=0.006）、平均压24±13 mmHg（<0.0001）。静息时舒张压PAP升高（>15 mmHg）的患者运动后PAP升高幅度更大。
运动后即刻使用CardioMEMS测量PAP是可行的。尽管病情得到了良好控制，但患者的功能能力仍严重受限。我们观察到步行时PAP显著升高，基线压力较高的患者升高幅度更大。
