• Mateusz Sokolski, Agnieszka Rydlewska, Bartosz Krakowiak, Jan Biegus, Robert Zymlinski, Waldemar Banasiak, Ewa Anita Jankowska, and Piotr Ponikowski.
• Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland. matsok@gmail.com
• J Cardiovasc Med (Hagerstown). 2011 Nov 1;12(11):773-8.

AimMeasurement of haemodynamic parameters using a Swan-Ganz catheter is of clinical importance in patients with advanced heart failure; however, its applicability is limited due to its invasiveness. The aim of the study was to estimate the concordance between invasive and non-invasive measurements of haemodynamic parameters in patients with advanced heart failure.Methods And ResultsWe examined 25 patients with advanced heart failure (20 men, age: 64 ± 11 years, New York Heart Association class III/IV: 88/12%, left ventricular ejection fraction: 37 ± 20%), 13 (52%) demonstrated decompensated heart failure. Resting haemodynamic parameters were measured simultaneously using two methods: an invasive Swan-Ganz catheterization and a thermodilution technique; and a non-invasive recording using a device for finger arterial pressure waveform analysis. The following parameters were analysed: stroke volume (SV, ml), cardiac output (CO, l/min) and systemic vascular resistance (SVR, dyne × s/cm⁵). The concordance between these two methods was assessed using the variability coefficient calculated according to a Bland-Altman method. Comparing the invasive and non-invasive measures, variability coefficients were: 13, 18 and 11% for SV, SVR and CO, respectively. Similar variability coefficients were obtained when invasive and non-invasive measurements were compared in prespecified subgroups of patients, distinguished based on the presence of decompensation, atrial fibrillation and values of SBP.ConclusionsEvaluation of haemodynamic parameters using a non-invasive method based on a pressure pulse contour model reveals an adequate concordance with the measures obtained using an invasive approach. Our results suggest that a non-invasive method for haemodynamic monitoring could be applied in clinical practice in patients with advanced heart failure.

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