PMID- 29352326
OWN - NLM
STAT- MEDLINE
DCOM- 20180924
LR  - 20191211
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Linking)
VI  - 107
IP  - 5
DP  - 2018 May
TI  - Noninvasive pulse contour analysis for determination of cardiac output in 
      patients with chronic heart failure.
PG  - 395-404
LID - 10.1007/s00392-017-1198-7 [doi]
AB  - BACKGROUND: Determination of cardiac output (CO) is essential in diagnosis and 
      management of heart failure (HF). The gold standard to obtain CO is invasive 
      assessment via thermodilution (TD). Noninvasive pulse contour analysis (NPCA) is 
      supposed as a new method of CO determination. However, a validation of this 
      method in HF is pending and performed in the present study. METHODS: Patients 
      with chronic-stable HF and reduced left ventricular ejection fraction 
      (LVEF </= 45%; HF-REF) underwent right heart catheterization including TD. NPCA 
      using the CNAP Monitor (V5.2.14, CNSystems Medizintechnik AG) was performed 
      simultaneously. Three standardized TD measurements were compared with 
      simultaneous auto-calibrated NPCA CO measurements. RESULTS: In total, 84 
      consecutive HF-REF patients were enrolled prospectively in this study. In 4 
      patients (5%), TD was not successful and for 22 patients (26%, 18 with left 
      ventricular assist device), no NPCA signal could be obtained. For the remaining 
      58 patients, Bland-Altman analysis revealed a mean bias of + 1.92 L/min (limits 
      of agreement +/- 2.28 L/min, percentage error 47.4%) for CO. With decreasing 
      cardiac index, as determined by the gold standard of TD, there was an increasing 
      gap between CO values obtained by TD and NPCA (r = - 0.75, p < 0.001), resulting 
      in a systematic overestimation of CO in more severe HF. TD-CI classified 52 (90%) 
      patients to have a reduced CI (< 2.5 L/min/m(2)), while NPCA documented a reduced 
      CI in 18 patients (31%) only. CONCLUSIONS: In HF-REF patients, auto-calibrated 
      NPCA systematically overestimates CO with decrease in cardiac function. 
      Therefore, to date, NPCA cannot be recommended in this cohort.
FAU - Roth, Sebastian
AU  - Roth S
AD  - Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, 
      Georgstrasse 11, 32545, Bad Oeynhausen, Germany.
FAU - Fox, Henrik
AU  - Fox H
AD  - Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, 
      Georgstrasse 11, 32545, Bad Oeynhausen, Germany.
FAU - Fuchs, Uwe
AU  - Fuchs U
AD  - Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, 
      Ruhr-Universitat Bochum, Georgstrasse 11, 32545, Bad Oeynhausen, Germany.
FAU - Schulz, Uwe
AU  - Schulz U
AD  - Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, 
      Ruhr-Universitat Bochum, Georgstrasse 11, 32545, Bad Oeynhausen, Germany.
FAU - Costard-Jackle, Angelika
AU  - Costard-Jackle A
AD  - Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, 
      Ruhr-Universitat Bochum, Georgstrasse 11, 32545, Bad Oeynhausen, Germany.
FAU - Gummert, Jan F
AU  - Gummert JF
AD  - Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, 
      Ruhr-Universitat Bochum, Georgstrasse 11, 32545, Bad Oeynhausen, Germany.
FAU - Horstkotte, Dieter
AU  - Horstkotte D
AD  - Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, 
      Georgstrasse 11, 32545, Bad Oeynhausen, Germany.
FAU - Oldenburg, Olaf
AU  - Oldenburg O
AD  - Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, 
      Georgstrasse 11, 32545, Bad Oeynhausen, Germany.
FAU - Bitter, Thomas
AU  - Bitter T
AD  - Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, 
      Georgstrasse 11, 32545, Bad Oeynhausen, Germany. akleemeyer@hdz-nrw.de.
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Validation Study
DEP - 20180119
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
SB  - IM
MH  - Aged
MH  - Arterial Pressure
MH  - Blood Pressure Determination/*methods/standards
MH  - Calibration
MH  - *Cardiac Output
MH  - Catheterization, Swan-Ganz
MH  - Chronic Disease
MH  - Female
MH  - Fingers/*blood supply
MH  - Heart Failure/*diagnosis/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Reference Standards
MH  - Reproducibility of Results
MH  - *Signal Processing, Computer-Assisted
MH  - Stroke Volume
MH  - Thermodilution
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - CNAP monitor
OT  - Cardiac output
OT  - Heart failure
OT  - Noninvasive pulse contour analysis
OT  - Pulmonary artery catheter
EDAT- 2018/01/21 06:00
MHDA- 2018/09/25 06:00
CRDT- 2018/01/21 06:00
PHST- 2017/08/25 00:00 [received]
PHST- 2017/12/20 00:00 [accepted]
PHST- 2018/01/21 06:00 [pubmed]
PHST- 2018/09/25 06:00 [medline]
PHST- 2018/01/21 06:00 [entrez]
AID - 10.1007/s00392-017-1198-7 [pii]
AID - 10.1007/s00392-017-1198-7 [doi]
PST - ppublish
SO  - Clin Res Cardiol. 2018 May;107(5):395-404. doi: 10.1007/s00392-017-1198-7. Epub 
      2018 Jan 19.