Husam M. Salah, Tamas Alexy, Ryan J. Tedford, Nicholas J. Hiivala, Max M. Owens, Liviu Klein, Marat Fudim
{"title":"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。","authors":"Husam M. Salah, Tamas Alexy, Ryan J. Tedford, Nicholas J. Hiivala, Max M. Owens, Liviu Klein, Marat Fudim","doi":"10.1002/ehf2.15374","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> Method and results</h3>\n \n <p>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; <i>P</i> < 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; <i>P</i> < 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; <i>P</i> < 0.001). Quartile analysis demonstrated that supine-seated differences were larger at lower mPAP levels and narrowed at higher pressures (<i>P</i> < 0.001). Seated mPAP trends showed modest increases prior to heart failure hospitalization.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 5","pages":"3399-3404"},"PeriodicalIF":3.7000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15374","citationCount":"0","resultStr":"{\"title\":\"Comparison of supine and sitting pulmonary pressures in ambulatory heart failure patients using the novel Cordella pulmonary pressure system\",\"authors\":\"Husam M. Salah, Tamas Alexy, Ryan J. Tedford, Nicholas J. Hiivala, Max M. Owens, Liviu Klein, Marat Fudim\",\"doi\":\"10.1002/ehf2.15374\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>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).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Method and results</h3>\\n \\n <p>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; <i>P</i> < 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; <i>P</i> < 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; <i>P</i> < 0.001). Quartile analysis demonstrated that supine-seated differences were larger at lower mPAP levels and narrowed at higher pressures (<i>P</i> < 0.001). Seated mPAP trends showed modest increases prior to heart failure hospitalization.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":11864,\"journal\":{\"name\":\"ESC Heart Failure\",\"volume\":\"12 5\",\"pages\":\"3399-3404\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-07-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15374\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ESC Heart Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ehf2.15374\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESC Heart Failure","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ehf2.15374","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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.
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.