Clifford, Rachel and Robson, Desiree and Gross, Christoph and Moscato, Francesco and Schima, Heinrich and Jansz, Paul and Macdonald, Peter S and Hayward, Christopher S (2018) Beat-to-beat detection of aortic valve opening in heartware left ventricular assist device patients. Artificial Organs, ePub. ISSN 0160564X (Not OA)
Full text not available from this repository.Abstract
BACKGROUND:
cfLVADs result in a significant reduction in aortic valve (AV) opening, which have been associated with several complications. Reliable monitoring of AV opening is needed to determine whether pump speed adjustment may be able to minimize adverse outcomes.
METHODS:
AV status was recorded continuously by echocardiography for 4 minutes in 3 states in 18 HeartWare HVAD patients: 2 minutes at rest, and 1 minute each following Valsalva maneuver and supine leg-raising. Using a previously described algorithm, beat-to-beat AV status was compared with the area under the curve of the normalised power spectral density analysis (PSD-AUC) for the corresponding beats of the pump speed waveform.
RESULTS:
5527 beats were analysed. AV opening varied between 0% and 100% for the cohort with the median AV opening frequency 21.5%, and median duration of opening of 124msec (range 0-279). The receiver operating characteristic (ROC) curve area for AV opening by the PSD-AUC algorithm was 0.95 (p<0.0001). A PSD-AUC cut-off of 0.82 distinguished between an open and closed AV with 86% sensitivity and 93% specificity. Accuracy was similar in regular cardiac rhythm, atrial fibrillation or with frequent ventricular ectopic beats. Valsalva maneuver and leg-raising had no impact on accuracy. The PSD-AUC was strongly predictive of AV opening duration (p<0.0001).
CONCLUSIONS:
AV status and opening duration can be determined with high accuracy on a beat-to-beat basis irrespective of cardiac rhythm and with low level exercise and changes in filling.
| Item Type: | Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Depositing User: | Repository Administrator |
| Date Deposited: | 05 Nov 2018 21:01 |
| Last Modified: | 05 Nov 2018 21:01 |
| URI: | https://eprints.victorchang.edu.au/id/eprint/770 |
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