Continuous Direct Left Atrial Pressure

Autor: Alberto Pozzoli, Francesco Maisano, Maurizio Taramasso, Marco Luciani, Shingo Kuwata, Adolfo Ferrero Guadagnoli, Oliver Gaemperli, Edwin C. Ho, Michel Zuber, Ted Feldman, Albert Czopak, Fabian Nietlispach, Matteo Saccocci
Rok vydání: 2019
Předmět:
Zdroj: JACC: Cardiovascular Interventions. 12:127-136
ISSN: 1936-8798
DOI: 10.1016/j.jcin.2018.07.051
Popis: Objectives The aim of this study was to assess the additional utility of measuring left atrial (LA) pressure as a complement to transesophageal echocardiography (TEE) and Doppler imaging. Background The efficacy of the MitraClip (MC) is assessed intraoperatively by TEE. However, TEE measures are operator dependent and can be influenced by left ventricular (LV) function and changes in LA compliance. Methods Fifty patients undergoing MC therapy with continuous left-sided heart pressure measurements were analyzed. LA V-wave pressure (LAvP), LA mean pressure (LAmP), LV systolic pressure, and LV end-diastolic pressure were measured continuously. LA pressures were indexed to LV pressures to account for changes in afterload during the procedure. Results Most patients (70%) had degenerative mitral regurgitation (MR). TEE MR grade decreased from 3+ to 0+. LAvP (p Conclusions This study demonstrates the value of real-time monitoring of LA pressure during MC therapy to predict clinical outcomes. An increase in LAmP was a predictive of worse clinical outcomes at short-term follow-up, independent from echocardiographic findings.
Databáze: OpenAIRE
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