Author + information
- Evrim Simseka,b,
- Emre Demira,b,
- Meral Kayikcioglua,b,
- Sanem Nalbantgila,b,
- Rashad Huseynova,b,
- Nesrin Mogolkoca,b,
- Levent Cana,b and
- Hakan Kultursaya,b
Background: Current guidelines recommend right heart catheterization and invasive cardiac output (CO) measurement with Fick or Thermodilution (TD) for diagnosis and clinical follow-up in pulmonary hypertension (PH). There is lack of evidence for routine clinical use of non- invasive measurements of CO with impedance cardiography (ICG) in PH. The purpose of our study was to compare Fick and TD techniques for CO measurement to ICG in PH patients.
Methods: All patients who had undergone right heart catheterization for PH from 2008 to 2015 were retrospectively searched. Indirect Fick method with estimated O2 consumption was used. NICCOMO (Medis, Medizinishe Messtechnik GmbH, and Ilmenau, GERMANY) device was used for ICG- CO measurements with arterial compliance modulation technique. Patients who had CO measurements with at least two different methods were included in the study. Three CO techniques were compared with each other for correlation and also to find out whether these tests are interchangeable between each other Bland Altman Analysis was performed.
Results: Two hundred and fifty four heart catheterizations were performed, 134 of them had CO results measured with at least two of the three investigated methods and had mean pulmonary artery pressure ≥25mmHg. Pearson correlation was performed for Fick vs. TD, Fick vs. ICG, and TD vs. ICG. There were significant correlations between all three methods. Fick vs. ICG had moderate correlation (n: 70, p<0.001, r: 0.469) Fick vs. TD and TD vs. ICG had strong correlations (consecutively (n: 111, p<0.001 r: 0.626, n: 47, p<0.001 r: 0.622) The mean difference (bias) between Fick vs. ICG, ICG vs. TD and Fick vs. TD were consecutively 0.9 ml/min.,-0.7 ml/min. and -0.3 ml/min but limits of agreement results were high.
Conclusions: There are conflicting results from small studies for comparisons of invasive methods and ICG method. According to related literature, this study is the largest study for the comparison of ICG vs. Fick and TD methods in PH patients. However ICG had strong correlation with TD but moderate correlation with Fick method. Also Fick and TD methods had good correlations; Bland Altman analysis proved that these tests were not interchangeable.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in Pulmonary Arterial Hypertension
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 1269-001
- 2017 American College of Cardiology Foundation