Validity of hemodynamic monitoring using inert gas rebreathing method in patients with chronic heart failure and those implanted with a left ventricular assist device

Nduka C Okwose; Noelia Bouzas-Cruz; Oscar Gonzalez Fernandez; Aaron Koshy; Thomas Green; Andrew Woods; Nicola Robinson-Smith; Sian Tovey; Adam McDiarmid; Gareth Parry; Stephan Schueler; Guy A MacGowan; Djordje G Jakovljevic

doi:10.1016/j.cardfail.2020.09.479

Validity of hemodynamic monitoring using inert gas rebreathing method in patients with chronic heart failure and those implanted with a left ventricular assist device

Nduka C Okwose, Noelia Bouzas-Cruz, Oscar Gonzalez Fernandez, Aaron Koshy, Thomas Green, Andrew Woods, Nicola Robinson-Smith, Sian Tovey, Adam McDiarmid, Gareth Parry, Stephan Schueler, Guy A MacGowan, Djordje G Jakovljevic

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Abstract

Objective: The present study assessed agreement between resting cardiac output estimated by inert gas rebreathing (IGR) and thermodilution methods in patients with heart failure and those implanted with a left ventricular assist device (LVAD). Methods and Results: Hemodynamic measurements were obtained in 42 patients, 22 with chronic heart failure and 20 with implanted continuous flow LVAD (34 males, aged 50 ± 11 years). Measurements were performed at rest using thermodilution and IGR methods. Cardiac output derived by thermodilution and IGR were not significantly different in LVAD (4.4 ± 0.9 L/min vs 4.7 ± 0.8 L/min, P =.27) or patients with heart failure (4.4 ± 1.4 L/min vs 4.5 ± 1.3 L/min, P =.75). There was a strong relationship between thermodilution and IGR cardiac index (r = 0.81, P =.001) and stroke volume index (r = 0.75, P =.001). Bland–Altman analysis showed acceptable limits of agreement for cardiac index derived by thermodilution and IGR, namely, the mean difference (lower and upper limits of agreement) for patients with heart failure –0.002 L/min/m ² (–0.65 to 0.66 L/min/m ²), and –0.14 L/min/m ² (–0.78 to 0.49 L/min/m ²) for patients with LVAD. Conclusions: IGR is a valid method for estimating cardiac output and should be used in clinical practice to complement the evaluation and management of chronic heart failure and patients with an LVAD.

Original language	English
Pages (from-to)	414-418
Number of pages	5
Journal	Journal of Cardiac Failure
Volume	27
Issue number	4
Early online date	7 Oct 2020
DOIs	https://doi.org/10.1016/j.cardfail.2020.09.479
Publication status	Published - 1 Apr 2021

Bibliographical note

NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Cardiac Failure. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Cardiac Failure, 27, (2021)
DOI: 10.1016/j.cardfail.2020.09.479

© 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

Keywords

cardiac output
heart failure
inert gas rebreathing
thermodilution

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.cardfail.2020.09.479

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Okwose, N. C., Bouzas-Cruz, N., Fernandez, O. G., Koshy, A., Green, T., Woods, A., Robinson-Smith, N., Tovey, S., McDiarmid, A., Parry, G., Schueler, S., MacGowan, G. A., & Jakovljevic, D. G. (2021). Validity of hemodynamic monitoring using inert gas rebreathing method in patients with chronic heart failure and those implanted with a left ventricular assist device. Journal of Cardiac Failure, 27(4), 414-418. https://doi.org/10.1016/j.cardfail.2020.09.479

Validity of hemodynamic monitoring using inert gas rebreathing method in patients with chronic heart failure and those implanted with a left ventricular assist device. / Okwose, Nduka C; Bouzas-Cruz, Noelia; Fernandez, Oscar Gonzalez et al.
In: Journal of Cardiac Failure, Vol. 27, No. 4, 01.04.2021, p. 414-418.

Research output: Contribution to journal › Article › peer-review

Okwose, NC, Bouzas-Cruz, N, Fernandez, OG, Koshy, A, Green, T, Woods, A, Robinson-Smith, N, Tovey, S, McDiarmid, A, Parry, G, Schueler, S, MacGowan, GA & Jakovljevic, DG 2021, 'Validity of hemodynamic monitoring using inert gas rebreathing method in patients with chronic heart failure and those implanted with a left ventricular assist device', Journal of Cardiac Failure, vol. 27, no. 4, pp. 414-418. https://doi.org/10.1016/j.cardfail.2020.09.479

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abstract = "Objective: The present study assessed agreement between resting cardiac output estimated by inert gas rebreathing (IGR) and thermodilution methods in patients with heart failure and those implanted with a left ventricular assist device (LVAD). Methods and Results: Hemodynamic measurements were obtained in 42 patients, 22 with chronic heart failure and 20 with implanted continuous flow LVAD (34 males, aged 50 ± 11 years). Measurements were performed at rest using thermodilution and IGR methods. Cardiac output derived by thermodilution and IGR were not significantly different in LVAD (4.4 ± 0.9 L/min vs 4.7 ± 0.8 L/min, P =.27) or patients with heart failure (4.4 ± 1.4 L/min vs 4.5 ± 1.3 L/min, P =.75). There was a strong relationship between thermodilution and IGR cardiac index (r = 0.81, P =.001) and stroke volume index (r = 0.75, P =.001). Bland–Altman analysis showed acceptable limits of agreement for cardiac index derived by thermodilution and IGR, namely, the mean difference (lower and upper limits of agreement) for patients with heart failure –0.002 L/min/m 2 (–0.65 to 0.66 L/min/m 2), and –0.14 L/min/m 2 (–0.78 to 0.49 L/min/m 2) for patients with LVAD. Conclusions: IGR is a valid method for estimating cardiac output and should be used in clinical practice to complement the evaluation and management of chronic heart failure and patients with an LVAD. ",

keywords = "cardiac output, heart failure, inert gas rebreathing, thermodilution",

author = "Okwose, {Nduka C} and Noelia Bouzas-Cruz and Fernandez, {Oscar Gonzalez} and Aaron Koshy and Thomas Green and Andrew Woods and Nicola Robinson-Smith and Sian Tovey and Adam McDiarmid and Gareth Parry and Stephan Schueler and MacGowan, {Guy A} and Jakovljevic, {Djordje G}",

note = "NOTICE: this is the author{\textquoteright}s version of a work that was accepted for publication in Journal of Cardiac Failure. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Cardiac Failure, 27, (2021) DOI: 10.1016/j.cardfail.2020.09.479 {\textcopyright} 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/",

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T1 - Validity of hemodynamic monitoring using inert gas rebreathing method in patients with chronic heart failure and those implanted with a left ventricular assist device

AU - Okwose, Nduka C

AU - Bouzas-Cruz, Noelia

AU - Fernandez, Oscar Gonzalez

AU - Koshy, Aaron

AU - Green, Thomas

AU - Woods, Andrew

AU - Robinson-Smith, Nicola

AU - Tovey, Sian

AU - McDiarmid, Adam

AU - Parry, Gareth

AU - Schueler, Stephan

AU - MacGowan, Guy A

AU - Jakovljevic, Djordje G

N1 - NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Cardiac Failure. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Cardiac Failure, 27, (2021) DOI: 10.1016/j.cardfail.2020.09.479 © 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

PY - 2021/4/1

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N2 - Objective: The present study assessed agreement between resting cardiac output estimated by inert gas rebreathing (IGR) and thermodilution methods in patients with heart failure and those implanted with a left ventricular assist device (LVAD). Methods and Results: Hemodynamic measurements were obtained in 42 patients, 22 with chronic heart failure and 20 with implanted continuous flow LVAD (34 males, aged 50 ± 11 years). Measurements were performed at rest using thermodilution and IGR methods. Cardiac output derived by thermodilution and IGR were not significantly different in LVAD (4.4 ± 0.9 L/min vs 4.7 ± 0.8 L/min, P =.27) or patients with heart failure (4.4 ± 1.4 L/min vs 4.5 ± 1.3 L/min, P =.75). There was a strong relationship between thermodilution and IGR cardiac index (r = 0.81, P =.001) and stroke volume index (r = 0.75, P =.001). Bland–Altman analysis showed acceptable limits of agreement for cardiac index derived by thermodilution and IGR, namely, the mean difference (lower and upper limits of agreement) for patients with heart failure –0.002 L/min/m 2 (–0.65 to 0.66 L/min/m 2), and –0.14 L/min/m 2 (–0.78 to 0.49 L/min/m 2) for patients with LVAD. Conclusions: IGR is a valid method for estimating cardiac output and should be used in clinical practice to complement the evaluation and management of chronic heart failure and patients with an LVAD.

AB - Objective: The present study assessed agreement between resting cardiac output estimated by inert gas rebreathing (IGR) and thermodilution methods in patients with heart failure and those implanted with a left ventricular assist device (LVAD). Methods and Results: Hemodynamic measurements were obtained in 42 patients, 22 with chronic heart failure and 20 with implanted continuous flow LVAD (34 males, aged 50 ± 11 years). Measurements were performed at rest using thermodilution and IGR methods. Cardiac output derived by thermodilution and IGR were not significantly different in LVAD (4.4 ± 0.9 L/min vs 4.7 ± 0.8 L/min, P =.27) or patients with heart failure (4.4 ± 1.4 L/min vs 4.5 ± 1.3 L/min, P =.75). There was a strong relationship between thermodilution and IGR cardiac index (r = 0.81, P =.001) and stroke volume index (r = 0.75, P =.001). Bland–Altman analysis showed acceptable limits of agreement for cardiac index derived by thermodilution and IGR, namely, the mean difference (lower and upper limits of agreement) for patients with heart failure –0.002 L/min/m 2 (–0.65 to 0.66 L/min/m 2), and –0.14 L/min/m 2 (–0.78 to 0.49 L/min/m 2) for patients with LVAD. Conclusions: IGR is a valid method for estimating cardiac output and should be used in clinical practice to complement the evaluation and management of chronic heart failure and patients with an LVAD.

KW - cardiac output

KW - heart failure

KW - inert gas rebreathing

KW - thermodilution

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Validity of hemodynamic monitoring using inert gas rebreathing method in patients with chronic heart failure and those implanted with a left ventricular assist device

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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