2018
DOI: 10.5935/abc.20180046
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Abstract: BackgroundPhysical examination and B-type natriuretic peptide (BNP) have been used to estimate hemodynamics and tailor therapy of acute decompensated heart failure (ADHF) patients. However, correlation between these parameters and left ventricular filling pressures is controversial.ObjectiveThis study was designed to evaluate the diagnostic accuracy of physical examination, chest radiography (CR) and BNP in estimating left atrial pressure (LAP) as assessed by tissue Doppler echocardiogram.MethodsPatients admit… Show more

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Cited by 2 publications
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“…Hemodynamic profiling has long been used to subgroup AHF patients by clinically-important differences in physiology, particularly in the relationship between cardiac index and vascular tone. Despite being recommended as part of routine AHF assessment in guidelines [ 1 , 22 , 23 ], invasive measures are so specialized and uncommon [ 19 ] that ED use is virtually unheard of, while current non-invasive methods [ 20 , 21 ] based on physical exam are subjective and lack sufficient interrater reliability [ 12 , 18 , 24 , 41 ] in the ED. Finger-cuff monitors are a non-invasive approach which provides objective data, and the replication of the exploratory cluster analysis results in the prior study’s DC [ 18 ] adds external validity to the observed profiles as a novel marker in ED AHF patients.…”
Section: Discussionmentioning
confidence: 99%
“…The device is highly accurate compared to invasive monitoring of MAP (R 2 = 0.96 [ 34 ], mean difference in MAP from finger cuff vs. invasive 4.2 mmHg {95%CI: 2.8–5.6 mmHg}), so if calculated in this way the error rate in SVRI would be unlikely to vary much from the error rate of cardiac index. Regardless, invasive monitoring is not feasible in the ED and physical exam based non-invasive alternatives are far more unreliable and inaccurate [ 12 , 18 , 24 , 41 ], making the error rate in finger-cuff monitors likely the best achievable in this patient population and setting at present. Moreover, the primary goals of this study were 1. to show that clustering of ED patients by finger-cuff monitor hemodynamics were repeatable in an external sample and unique from patients without AHF and 2. to show that these profiles were associated with clinically important outcomes in ED AHF patients such as mortality and the ranked composite outcome.…”
Section: Discussionmentioning
confidence: 99%