Could Impedance Cardiography be a Non-Invasive Alternative Method of Measuring Cardiac Output in Patients with Pulmonary Hypertension?
Background: Pulmonary hypertension guidelines recommend invasive right heart catheterization for diagnosis and clinical follow-up. Our aim was to compare non-invasive impedance cardiography with invasive techniques for cardiac index measurements and mortality prediction in patients with pulmonary hy...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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KARE Publishing
2023-10-01
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| Series: | Anatolian Journal of Cardiology |
| Subjects: | |
| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-49587 |
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| author | Burcu Yağmur Evrim Şimşek Meral Kayıkçıoğlu Elif İlkay Yüce Yeşim Bayazıt Candemir Sanem Nalbantgil Nesrin Moğolkoç Levent Can Hakan Kültürsay |
| author_facet | Burcu Yağmur Evrim Şimşek Meral Kayıkçıoğlu Elif İlkay Yüce Yeşim Bayazıt Candemir Sanem Nalbantgil Nesrin Moğolkoç Levent Can Hakan Kültürsay |
| author_sort | Burcu Yağmur |
| collection | DOAJ |
| description | Background: Pulmonary hypertension guidelines recommend invasive right heart catheterization for diagnosis and clinical follow-up. Our aim was to compare non-invasive impedance cardiography with invasive techniques for cardiac index measurements and mortality prediction in patients with pulmonary hypertension.
Methods: Between 2008 and 2018, 284 right heart catheterizations were performed for the diagnosis of pulmonary hypertension in 215 patients with mean pulmonary artery pressure >25 mm Hg, and at least 2 methods used for cardiac output measurement were included in the study retrospectively. Patients were evaluated with Pearson's correlation in 3 groups: estimated Fick (eFick) method and thermodilution (group 1), eFick method and impedance cardiography (group 2), and thermodilution and impedance cardiography (group 3). We also compared the predictive power of cardiac index measured by different methods for 1-year overall mortality and hospitalizations.
Results: There were strong and moderate positive correlations in groups 1 and 3, respectively (r = 0.634, P <.001, r = 0.534, P =.001), and the weakest correlation was in group 2 (r = 0.390, P =.001). The mean difference (bias) between eFick method versus impedance cardiography, impedance cardiography vs. thermodilution, and eFick method vs.
thermodilution was 0.6 mL/min, 0.47 mL/min, and −0.2 mL/min respectively, but limits of agreement were wide. In both groups, cardiac index <2.5 L/min/m2 as measured by thermodilution significantly predicted 1-year mortality. Also, impedance cardiography was better than eFick method in predicting mortality (P =.02).
Conclusions: Our single-center real-life data showed that for cardiac output and cardiac index measurements, impedance cardiography provides a moderate correlation with thermodilution and is fair with eFick method methods. Moreover, thermodilution appeared superior to both eFick method and impedance cardiography, while impedance cardiography was even better than eFick method in predicting 1-year adverse events, including total mortality and hospitalization, in patients with pulmonary hypertension. |
| first_indexed | 2024-03-11T14:11:43Z |
| format | Article |
| id | doaj.art-e930575066534ef2804979a0b6377cc0 |
| institution | Directory Open Access Journal |
| issn | 2149-2271 |
| language | English |
| last_indexed | 2024-03-11T14:11:43Z |
| publishDate | 2023-10-01 |
| publisher | KARE Publishing |
| record_format | Article |
| series | Anatolian Journal of Cardiology |
| spelling | doaj.art-e930575066534ef2804979a0b6377cc02023-11-01T19:47:38ZengKARE PublishingAnatolian Journal of Cardiology2149-22712023-10-01271165065610.14744/AnatolJCardiol.2023.2820AJC-49587Could Impedance Cardiography be a Non-Invasive Alternative Method of Measuring Cardiac Output in Patients with Pulmonary Hypertension?Burcu Yağmur0Evrim Şimşek1Meral Kayıkçıoğlu2Elif İlkay Yüce3Yeşim Bayazıt Candemir4Sanem Nalbantgil5Nesrin Moğolkoç6Levent Can7Hakan Kültürsay8Department of Cardiology, Faculty of Medicine, Ege University, İzmir, TürkiyeDepartment of Cardiology, Faculty of Medicine, Ege University, İzmir, TürkiyeDepartment of Cardiology, Faculty of Medicine, Ege University, İzmir, TürkiyeDepartment of Cardiology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, TürkiyeDepartment of Cardiology, Faculty of Medicine, Ege University, İzmir, TürkiyeDepartment of Cardiology, Faculty of Medicine, Ege University, İzmir, TürkiyeDepartment of Pulmonology, Faculty of Medicine, Ege University, İzmir, TürkiyeDepartment of Cardiology, Faculty of Medicine, Ege University, İzmir, TürkiyeDepartment of Cardiology, Faculty of Medicine, Ege University, İzmir, TürkiyeBackground: Pulmonary hypertension guidelines recommend invasive right heart catheterization for diagnosis and clinical follow-up. Our aim was to compare non-invasive impedance cardiography with invasive techniques for cardiac index measurements and mortality prediction in patients with pulmonary hypertension. Methods: Between 2008 and 2018, 284 right heart catheterizations were performed for the diagnosis of pulmonary hypertension in 215 patients with mean pulmonary artery pressure >25 mm Hg, and at least 2 methods used for cardiac output measurement were included in the study retrospectively. Patients were evaluated with Pearson's correlation in 3 groups: estimated Fick (eFick) method and thermodilution (group 1), eFick method and impedance cardiography (group 2), and thermodilution and impedance cardiography (group 3). We also compared the predictive power of cardiac index measured by different methods for 1-year overall mortality and hospitalizations. Results: There were strong and moderate positive correlations in groups 1 and 3, respectively (r = 0.634, P <.001, r = 0.534, P =.001), and the weakest correlation was in group 2 (r = 0.390, P =.001). The mean difference (bias) between eFick method versus impedance cardiography, impedance cardiography vs. thermodilution, and eFick method vs. thermodilution was 0.6 mL/min, 0.47 mL/min, and −0.2 mL/min respectively, but limits of agreement were wide. In both groups, cardiac index <2.5 L/min/m2 as measured by thermodilution significantly predicted 1-year mortality. Also, impedance cardiography was better than eFick method in predicting mortality (P =.02). Conclusions: Our single-center real-life data showed that for cardiac output and cardiac index measurements, impedance cardiography provides a moderate correlation with thermodilution and is fair with eFick method methods. Moreover, thermodilution appeared superior to both eFick method and impedance cardiography, while impedance cardiography was even better than eFick method in predicting 1-year adverse events, including total mortality and hospitalization, in patients with pulmonary hypertension.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-49587hemodynamicsimpedance cardiographymortalitynoninvasive assessmentpulmonary circulation and right ventricular |
| spellingShingle | Burcu Yağmur Evrim Şimşek Meral Kayıkçıoğlu Elif İlkay Yüce Yeşim Bayazıt Candemir Sanem Nalbantgil Nesrin Moğolkoç Levent Can Hakan Kültürsay Could Impedance Cardiography be a Non-Invasive Alternative Method of Measuring Cardiac Output in Patients with Pulmonary Hypertension? Anatolian Journal of Cardiology hemodynamics impedance cardiography mortality noninvasive assessment pulmonary circulation and right ventricular |
| title | Could Impedance Cardiography be a Non-Invasive Alternative Method of Measuring Cardiac Output in Patients with Pulmonary Hypertension? |
| title_full | Could Impedance Cardiography be a Non-Invasive Alternative Method of Measuring Cardiac Output in Patients with Pulmonary Hypertension? |
| title_fullStr | Could Impedance Cardiography be a Non-Invasive Alternative Method of Measuring Cardiac Output in Patients with Pulmonary Hypertension? |
| title_full_unstemmed | Could Impedance Cardiography be a Non-Invasive Alternative Method of Measuring Cardiac Output in Patients with Pulmonary Hypertension? |
| title_short | Could Impedance Cardiography be a Non-Invasive Alternative Method of Measuring Cardiac Output in Patients with Pulmonary Hypertension? |
| title_sort | could impedance cardiography be a non invasive alternative method of measuring cardiac output in patients with pulmonary hypertension |
| topic | hemodynamics impedance cardiography mortality noninvasive assessment pulmonary circulation and right ventricular |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-49587 |
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