Accuracy of Swan‒Ganz catheterization‐based assessment of right ventricular function: Validation study using high‐fidelity micromanometry‐derived values as reference

Abstract

Right ventricular (RV) function critically affects the outcomes of patients with pulmonary hypertension (PH). Pressure wave analysis using Swan-Ganz catheterization (SG-cath) allows for the calculation of indices of RV function. However, the accuracy of these indices has not been validated. In the present study, we calculated indices of systolic and diastolic RV functions using SG-cath-derived pressure recordings in patients with suspected or confirmed PH. We analyzed and validated the accuracies of three RV indices having proven prognostic values, that is, end-systolic elastance (Ees)/arterial elastance (Ea), β (stiffness constant), and end-diastolic elastance (Eed), using high-fidelity micromanometry-derived data as reference. We analyzed 73 participants who underwent SG-cath for the diagnosis or evaluation of PH. In this study, Ees/Ea was calculated via the single-beat pressure method using [1.65 × (mean pulmonary arterial pressure) − 7.79] as end-systolic pressure. SG-cath-derived Ees/Ea, β, and Eed were 0.89 ± 0.69 (mean ± standard deviation), 0.027 ± 0.002, and 0.16 ± 0.02 mmHg/ml, respectively. The mean differences (limits of agreement) between SG-cath and micromanometryderived data were 0.13 (0.99, −0.72), 0.002 (0.020, −0.013), and 0.04 (0.20, −0.12) for Ees/Ea, β, and Eed, respectively. The intraclass correlation coefficients of the indices derived from the two catheterizations were 0.76, 0.71, and 0.57 for Ees/Ea, β, and Eed, respectively. In patients with confirmed or suspected PH, SG-cath-derived RV indices, especially Ees/Ea and β, exhibited a good correlation with micromanometry-derived reference values.

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Deep learning to assess right ventricular ejection fraction from two‐dimensional echocardiograms in precapillary pulmonary hypertension

“…Right heart catheterization was performed using a Swan‐Ganz catheter. From the pressure records, we measured the mean right atrial, PA, and PA wedge pressure 12 . Stroke volume and cardiac output were measured using the thermodilution method, and pulmonary vascular resistance was calculated as follows: (mean PA pressure− mean PA wedge pressure)/cardiac output.…”

Exploratory analysis of the accuracy of echocardiographic parameters for the assessment of right ventricular function and right ventricular–pulmonary artery coupling

“…Image acquisition and analysis were performed using a previously described protocol. 24 Briefly, cine MRI was performed in the axial plane covering the whole heart, using a steady‐state free precession pulse sequence. The details of the parameters are provided in Supporting Information S12: Table 1 .…”

“…For the calculation of Piso, we applied the single‐beat method, 29 in which mathematical curve fitting of RVP data during isovolumic contraction and relaxation were exerted using a dedicated software (LabChart Pro®, ADInstruments), as described in our previous study. 24 τ was calculated using the Weiss method. 30 …”

“…For the calculation of Piso, we applied the singlebeat method, 29 in which mathematical curve fitting of RVP data during isovolumic contraction and relaxation were exerted using a dedicated software (LabChart Pro®, ADInstruments), as described in our previous study. 24 τ was calculated using the Weiss method. 30 Ees was calculated using the following formula: Ees = (Piso − Pes)/RVSV (1), where end systolic pressure (Pes) was calculated as Pes = 1.65 × MPAP − 7.79, 31 with MPAP measured using a pressure catheter.…”