Noninvasive and Simple Assessment of Cardiac Output and Pulmonary Vascular Resistance With Whole-Body Impedance Cardiography Is Useful for Monitoring Patients With Pulmonary Hypertension

Taniguchi, Yu; Emoto, Noriaki; Miyagawa, Kazuya; Nakayama, Keiichi I.; Kinutani, Hiroto; Tanaka, Hidekazu; Shinke, Toshiro; Hirata, Ken‐ichi

doi:10.1253/circj.cj-13-0172

Cited by 25 publications

(27 citation statements)

References 27 publications

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“…In another study of 65 patients with precapillary pulmonary Figure 1 Bland-Altman plots comparing cardiac output measured by impedance cardiography (CO ICG ), thermodilution (CO TD ) and cardiac magnetic resonance (CO CMR ): (a) CO ICG versus CO TD at rest; (b) CO ICG versus CO CMR at rest; (c) CO ICG versus CO TD at exercise; (d) change in CO ICG versus change in CO TD from rest to exercise; (e) CO TD versus CO CMR at rest. hypertension, whole-body ICG showed good correlation with TD (r = 0Á715) and Fick (r = 0Á653) and satisfactory agreement with both methods in the measurement of resting cardiac output (bias: 0Á50, 95% CI: À1Á61 to 2Á61 l min À1 versus TD; bias: À0Á54, 95% CI: À2Á57 to 1Á49 l min À1 versus Fick) (Taniguchi et al, 2013). Finally, transthoracic bioreactance cardiography, a similar technology to ICG, showed acceptable results versus TD (r = 0Á60, bias: À0Á81, 95% CI: À3Á54 to 1Á92) and Fick (r = 0Á54, bias: 0Á02, 95% CI: À2Á41 to 2Á44) in the measurement of resting cardiac output in 50 patients with pulmonary hypertension of various aetiologies (Rich et al, 2013).…”

Section: Discussionmentioning

confidence: 79%

Validation of impedance cardiography in pulmonary arterial hypertension

Panagiotou

Vogiatzis

Jayasekera

et al. 2017

Clin Physio Funct Imaging

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Summary Background Non‐invasive methods of measuring cardiac output are highly desirable in pulmonary arterial hypertension (PAH). We therefore sought to validate impedance cardiography (ICG) against thermodilution (TD) and cardiac magnetic resonance (CMR) in the measurement of cardiac output in patients under investigation for PAH. Methods A prospective, cross‐sectional study was performed to compare single‐point measurements of cardiac output obtained by impedance cardiography (COICG) technology (PhysioFlow®) with (i) contemporaneous TD measurements (COTD) at rest and steady‐state exercise during right heart catheterization and (ii) CMR measurements (COCMR) at rest obtained within 72 h. Results Paired COICG and COTD measurements were obtained in 25 subjects at rest and 16 subjects at exercise. COCMR measurements were obtained in 16 subjects at rest. There was unsatisfactory correlation and agreement between COICG and COTD at rest (r = 0·42, P = 0·035; bias: 1·21 l min−1, 95% CI: −2·33 to 4·75 l min−1) and exercise (r = .65, P = .007; bias: 1·41 l min−1; 95% CI: −3·99 to 6·81 l min−1) and in the change in COICG and COTD from rest to exercise (r = 0·53, P = 0·033; bias: 0·76 l min−1, 95% CI: −3·74 to 5·26 l min−1). There was also a lack of correlation and unsatisfactory agreement between resting COICG and COCMR (r = 0·38, P = 0·1; bias: 1·40 l min−1, 95% CI: −2·48 to 5·28 l min−1). In contrast, there was close correlation and agreement between resting COTD and COCMR (r = 0·87, P<0·001; bias: −0·16 l min−1, 95% CI: −1·97 to 1·65). Conclusions In a representative population of patients under investigation for PAH, ICG showed insufficient qualitative and quantitative value in the measurement of resting and exercise cardiac output when compared with TD and CMR.

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Section: Discussionmentioning

confidence: 79%

Validation of impedance cardiography in pulmonary arterial hypertension

Panagiotou

Vogiatzis

Jayasekera

et al. 2017

Clin Physio Funct Imaging

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“…52 In contrast, other biomarkers of endothelial activation, regeneration and injury, method of estimating cardiac output and PVR using impedance cardiography, Non Invasive Cardiac System (NICaS) and echocardiography was shown to have a good correlation with right heart catheterization Fick-calculated PVR (receiver-operating characteristic area under the curve (ROC AUC) 0.92, sensitivity 80.3%, specificity 100%) but not with thermodilution (ROC AUC 0.84, sensitivity 81.3%, specificity 75%). 24 Acute vasodilator testing is used to test the reactivity of the pulmonary vascular bed, 1 either with oxygen 25 or inhaled nitric oxide (iNO). 26, 27 Berner et al showed that, among patients with long-standing large left-to-right shunts and elevated PVR, there is a marked heterogeneity of response to acute vasodilator challenge with iNO, ranging from a marked pulmonary vasodilatation to a complete lack of vascular reactivity.…”

Section: Myers Po Et Almentioning

confidence: 99%

Assessment of Operability of Patients With Pulmonary Arterial Hypertension Associated With Congenital Heart Disease

Myers

Tissot

Beghetti

2014

Circ J

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4MYERS PO et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jp dvances in cardiac care have allowed the repair of congenital heart defects (CHD) in the neonatal period or in infancy for most patients, before the development of pulmonary arterial hypertension (PAH) and pulmonary vascular disease (PVD) from pulmonary overcirculation. Nonetheless, PAH associated with CHD remains a problem, mainly in patients in whom the left-to-right shunt wasn't diagnosed until childhood or even adulthood, or in patients who didn't have access to cardiovascular care and surgical management as infants, particularly in developing countries. 1 The current definition of PAH relies on a pulmonary arterial pressure ≥25 mmHg at rest, a left atrial pressure ≤15 mmHg, and normal resting cardiac output, suggesting a resting pulmonary vascular resistance of ≥3 Woods units. 2,3 The 2009 European Society of Cardiology (ESC)/European Respiratory Society (ERS)/Internation Society of Heart and Lung Transplantation (ISHLT) guidelines on the management of PAH subdivided PAH-CHD into 4 clinical groups: (1) Eisenmenger syndrome; (2) PAH associated with systemic-to-pulmonary shunts; (3) PAH with small defects; and (4) PAH after surgical repair. 3 PAH and pulmonary vascular lesions are thought to be reversed after surgery in some patients when operated on early in life. In others, PAH is thought to be irreversible and the prognosis is often worse than without surgery. 4 Patients with persistent or recurrent PAH after surgery have been shown to have worse outcomes than either those with unoperated CHD and PAH or with Eisenmenger's syndrome in a single-center retrospective review. 5 PAH in CHD is also an increasing problem, with an increasing number and proportion of patients with CHD reported in PAH registries both in adults and children. For example, in the Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension (TOPP) registry, CHD patients represent 40% of included patients, 35% of which previously had surgical repair. 6 With improvement in pulmonary vasodilators and their more widespread use, it has been possible to reduce pulmonary vascular resistance (PVR) and symptoms in a subset of patient with PAH, and make these patients amenable to surgery. 1 However, most of the results provide only short-term outcomes and immediate post-operative survival does not always translate into long-term success. Given this shifting paradigm, this review focuses on how to assess operability and how novel pulmonary vasodilators are changing the management of PAH in CHD and opening new research prospects. Literature Search StrategyRigorous electronic and manual literature searches were conducted to identify reports of PAH in CHD, their assessment, operability and treatment. Articles were identified in electronic database searches of Medline, Embase and the Cochrane Library, using a predetermined search strategy including the Pulmonary arterial hypertension (PAH) is a common complication of congenital h...

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“…11 In patients with moderate PH, the ICGT-derived CO has been reported to show a good correlation with RHC-derived CO. 12 In this issue of the Journal, Taniguchi et al report that a noninvasive cardiac system (NICaS: NI Medical, Hod-Hasharon, Israel) is an accurate tool for noninvasively and serially measuring CO in patients with moderate PH. 13 This system noninvasively determines CO based on another ICG method, whole-body impedance cardiography (ICGWB), which involves electrodes placed on 1 wrist and on the contralateral ankle ( Figure). The study demonstrated that NICaS-derived CO determinations correlate well with thermodilution-and Fick-derived CO measurements.…”

Section: Noninvasive Measurement Of Co In Ph Using Impedance Cardiogrmentioning

confidence: 99%

Noninvasive and Accurate Evaluation of Cardiac Output in Patients With Pulmonary Hypertension

Abe

2013

Circ J

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Noninvasive and Simple Assessment of Cardiac Output and Pulmonary Vascular Resistance With Whole-Body Impedance Cardiography Is Useful for Monitoring Patients With Pulmonary Hypertension

Cited by 25 publications

References 27 publications

Validation of impedance cardiography in pulmonary arterial hypertension

Validation of impedance cardiography in pulmonary arterial hypertension

Assessment of Operability of Patients With Pulmonary Arterial Hypertension Associated With Congenital Heart Disease

Noninvasive and Accurate Evaluation of Cardiac Output in Patients With Pulmonary Hypertension

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