使用新型Cordella肺动脉压系统的非卧床心力衰竭患者仰卧位和坐位肺动脉压的比较。

IF 3.7 2区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Husam M. Salah, Tamas Alexy, Ryan J. Tedford, Nicholas J. Hiivala, Max M. Owens, Liviu Klein, Marat Fudim
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引用次数: 0

摘要

目的:本研究的目的是研究使用Cordella HF管理系统(Cordella)测量心力衰竭(HF)患者仰卧位和坐位肺动脉压(PAP)之间的关系。方法和结果:纳入来自sirona2和PROACTIVE-HF试验的成对仰卧和坐位PAP读数。共有504名NYHA III级HF患者贡献了40115个配对测量。平均仰卧位平均PAP (mPAP)为29.1±11.6 mmHg,而平均坐位mPAP为22.1±12.2 mmHg(仰卧位相差7.1±6.5 mmHg,相关性= 0.85;P)结论:本研究对仰卧位和坐位PAP进行了最大的对比,并证明了坐位和仰卧位PAP测量之间的高度相关性。仰卧位的差异可能反映了静脉容量和预负荷储备,为HF表型提供了新的生理学见解。对于有PAP传感器的HF患者,坐式PAP测量是一种有效和可靠的替代仰卧测量的方法。考虑到患者对坐位测量的偏好及其更能反映日常生理状态,将坐位PAP纳入常规监测可能会提高依从性并优化心衰远程管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Comparison of supine and sitting pulmonary pressures in ambulatory heart failure patients using the novel Cordella pulmonary pressure system

Comparison of supine and sitting pulmonary pressures in ambulatory heart failure patients using the novel Cordella pulmonary pressure system

Aims

The aim of this study is to examine the relationship between supine and seated pulmonary artery pressure (PAP) measurements using the CordellaTM HF management system (Cordella) in patients with heart failure (HF).

Method and results

Paired supine and seated PAP readings from the SIRONA 2 and PROACTIVE-HF trials were included. A total of 504 NYHA class III HF patients contributed 40 115 paired measurements. Mean supine mean PAP (mPAP) was 29.1 ± 11.6 mmHg compared with a mean seated mPAP of 22.1 ± 12.2 mmHg (supine-seated difference 7.1 ± 6.5 mmHg, correlation = 0.85; P < 0.001); mean supine sPAP was 44.4 ± 16.6 mmHg compared to a mean seated sPAP 35.4 ± 17.8 mmHg (supine-seated difference 9.0 ± 8.5 mmHg, correlation = 0.88; P < 0.001); and mean supine dPAP was 19.1 ± 9.5 mmHg compared to a mean seated dPAP of 13.9 ± 9.5 mmHg (supine-seated difference 5.2 ± 5.6 mmHg, correlation = 0.82; P < 0.001). Quartile analysis demonstrated that supine-seated differences were larger at lower mPAP levels and narrowed at higher pressures (P < 0.001). Seated mPAP trends showed modest increases prior to heart failure hospitalization.

Conclusions

This study presents the largest paired comparison of supine and sitting PAP and demonstrates a high degree of correlation between seated and supine measures of PAP. Supine-seated differences may reflect venous capacitance and preload reserve, providing novel physiologic insights into HF phenotyping. Seated PAP measurements are a valid and reliable alternative to supine measurements for HF patients with PAP sensors. Given patient preference for seated measurements and their closer reflection of daily physiologic status, incorporating seated PAP into routine monitoring may enhance adherence and optimize remote HF management.

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来源期刊
ESC Heart Failure
ESC Heart Failure Medicine-Cardiology and Cardiovascular Medicine
CiteScore
7.00
自引率
7.90%
发文量
461
审稿时长
12 weeks
期刊介绍: ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.
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