University of Sheffield, Sheffield, UK.
Sheffield University Teaching Hospitals NHS Trust, Sheffield, UK.
Sci Rep. 2023 Nov 22;13(1):20528. doi: 10.1038/s41598-023-47612-9.
In patients with heart failure, guideline directed medical therapy improves outcomes and requires close patient monitoring. Pulmonary artery pressure monitors permit remote assessment of cardiopulmonary haemodynamics and facilitate early intervention that has been shown to decrease heart failure hospitalization. Pressure sensors implanted in the pulmonary vasculature are stabilized through passive or active interaction with the anatomy and communicate with an external reader to relay invasively measured pressure by radiofrequency. A body mass index > 35 kg/m and chest circumference > 165 cm prevent use due to poor communication. Pulmonary vasculature anatomy is variable between patients and the pulmonary artery size, angulation of vessels and depth of sensor location from the chest wall in heart failure patients who may be candidates for pressure sensors remains largely unexamined. The present study analyses the size, angulation, and depth of the pulmonary artery at the position of implantation of two pulmonary artery pressure sensors: the CardioMEMS sensor typically implanted in the left pulmonary artery and the Cordella sensor implanted in the right pulmonary artery. Thirty-four computed tomography pulmonary angiograms from patients with heart failure were analysed using the MIMICS software. Distance from the bifurcation of the pulmonary artery to the implant site was shorter for the right pulmonary artery (4.55 ± 0.64 cm vs. 7.4 ± 1.3 cm) and vessel diameter at the implant site was larger (17.15 ± 2.87 mm vs. 11.83 ± 2.30 mm). Link distance (length of the communication path between sensor and reader) was shorter for the left pulmonary artery (9.40 ± 1.43 mm vs. 12.54 ± 1.37 mm). Therefore, the detailed analysis of pulmonary arterial anatomy using computed tomography pulmonary angiograms may alter the choice of implant location to reduce the risk of sensor migration and improve readability by minimizing sensor-to-reader link distance.
在心力衰竭患者中，指南指导的医学治疗可改善预后，并需要密切监测患者。肺动脉压力监测器可远程评估心肺血液动力学，并有助于早期干预，已证明这可以减少心力衰竭住院治疗。植入肺动脉中的压力传感器通过与解剖结构的被动或主动相互作用而稳定，并通过射频与外部读取器通信以传递侵入性测量的压力。由于沟通不畅，身体质量指数（BMI）>35kg/m 和胸围>165cm 会阻止使用。患者之间的肺动脉解剖结构存在差异，并且在可能适合使用压力传感器的心力衰竭患者中，肺动脉大小、血管角度以及传感器相对于胸壁的位置深度在很大程度上尚未得到研究。本研究分析了两个肺动脉压力传感器（通常植入左肺动脉的 CardioMEMS 传感器和植入右肺动脉的 Cordella 传感器）植入部位的肺动脉大小、角度和深度。使用 MIMICS 软件分析了 34 例心力衰竭患者的计算机断层肺动脉造影（CTPA）。右肺动脉植入部位与肺动脉分叉的距离更短（4.55±0.64cm 比 7.4±1.3cm），植入部位的血管直径更大（17.15±2.87mm 比 11.83±2.30mm）。左肺动脉的链接距离（传感器和读取器之间的通信路径长度）更短（9.40±1.43mm 比 12.54±1.37mm）。因此，使用 CTPA 对肺动脉解剖结构进行详细分析可能会改变植入位置的选择，以降低传感器迁移的风险，并通过最小化传感器到读取器的链接距离来提高可读性。
