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J Am Coll Cardiol, 2003; 41:565-571, doi:10.1016/S0735-1097(02)02896-6
© 2003 by the American College of Cardiology Foundation
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Ongoing right ventricular hemodynamics in heart failure

clinical value of measurements derived from an implantable monitoring system

Philip B. Adamson, MD, FACC*{dagger},*, Anthony Magalski, MD, FACC{ddagger}, Frieder Braunschweig, MD§, Michael Böhm, MD||, Dwight Reynolds, MD, FACC*, David Steinhaus, MD, FACC{ddagger}, Allyson Luby, RN*, Cecilia Linde, MD§, Lars Ryden, MD§, Bodo Cremers, MD||, Teri Takle, MSc and Tom Bennett, PhD

* Department of Internal Medicine, Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
{dagger} Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
{ddagger} Mid-America Heart Institute, Kansas City, Kansas, USA
§ Cardiology Department, Karolinska Hospital, Stockholm, Sweden
|| University Clinic, Homburg/Saar, Germany
Medtronic Heart Failure Management, Minneapolis, Minnesota, USA



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Figure 1 Actual right ventricular pressure waveforms derived from an implantable hemodynamic monitor (IHM) system, with an illustration of how the IHM determines the pressure values. dP/dt = contractility as measured by change in pressure over change in time; EGM = electrogram; ePAD = estimated pulmonary artery diastolic pressure; RVDP = right ventricular diastolic pressure; RVSP = right ventricular systolic pressure.

 


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Figure 2 Right ventricular pressure values from a patient with variable pressure (left panel) and a patient with nonvariable pressure (right panel) characteristics. (See text for details.) Nighttime minimum values are shown for heart rate (HR), RVSP, ePAD, and RVDP values. Abbreviations as in Figure 1.

 


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Figure 3 (A) Pressure changes occurred in 9 of 12 events 4 ± 2 days before hospitalization (major). (B) Pressure changes before minor exacerbations (n = 24) that did not require hospitalization. Percent changes in right ventricular systolic pressure (black circles), estimated pulmonary artery diastolic pressure (green diamonds), and heart rate (red triangles).

 




 
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