The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Harry A Silber - One of the best experts on this subject based on the ideXlab platform.
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usefulness of noninvasively measured pulse amplitude changes during the valsalva maneuver to identify hospitalized heart failure patients at risk of 30 day heart failure events from the pressure hf study
American Journal of Cardiology, 2020Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Steven P Schulman, Ryan J Tedford, Stuart D Russell, Gayane Yenokyan, Harry A SilberAbstract:The pulse amplitude ratio (PAR), the ratio of pulse pressure at the end of the Valsalva maneuver to before the onset, correlates with cardiac filling pressure. We have developed a handheld device that uses finger Photoplethysmography to measure PAR and estimate left ventricular end diastolic pressure (LVEDP). Patients hospitalized with heart failure (HF) performed three 10-second trials of a standardized Valsalva maneuver (at 20 mm Hg measured via pressure transducer), while Photoplethysmography waveforms were recorded, at admission and discharge. Combined primary outcome was 30-day HF hospitalization, intravenous diuresis, or death. Fifty-two subjects had discharge PAR testing; 12 met the primary outcome. Median PAR on admission was 0.55 (interquartile range: 0.40 to 0.70, n = 48) and on discharge was 0.50 (interquartile range: 0.36 to 0.69). Mean PAR-estimated LVEDP was significantly higher in subjects that had an event (20.2 vs 16.9 mm Hg, p = 0.043). Subjects with PAR-estimated LVEDP >19.5 mm Hg had an event rate hazard ratio of 4.57 (95% confidence interval 1.37, 15.19, p = 0.013) compared with patients with LVEDP 19.5 mm Hg or below, with significantly lower 30-day event-free survival (log-rank p = 0.006). In conclusion, noninvasively estimated LVEDP using the pulse amplitude response to a Valsalva maneuver in patients hospitalized for HF changes with diuresis and identifies patients at high risk for 30-day HF events. Detection of elevated filling pressures before hospital discharge may be useful in guiding HF management to reduce HF events.
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usefulness of pulse amplitude changes during the valsalva maneuver measured using finger Photoplethysmography to identify elevated pulmonary capillary wedge pressure in patients with heart failure
American Journal of Cardiology, 2017Co-Authors: Nisha A Gilotra, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Kavita Sharma, Harry A SilberAbstract:The pulse amplitude ratio, the ratio of pulse pressure at the end of a Valsalva maneuver to before the onset of Valsalva, correlates with filling pressure. This study aimed to noninvasively estimate cardiac filling pressure in patients with heart failure. We developed a noninvasive handheld device to measure pulse amplitude ratio using finger Photoplethysmography. In 69 patients who underwent right heart catheterization, Photoplethysmography waveforms were recorded during a standardized Valsalva maneuver, and in 60 of these patients, pulse amplitude ratio was able to be calculated. Pulse amplitude ratio correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.58, p 2 of 0.54. Difference in mean pulse amplitude ratio for subjects with a PCWP ≤15 mm Hg versus >15 mm Hg was statistically significant (p ≥ 0.55 predicted PCWP > 15 mm Hg with 73% sensitivity and 77% specificity. Pulse amplitude ratio also increased by an average of 0.03 with a leg raise maneuver (p = 0.05, n = 36). In conclusion, we demonstrate that noninvasively measured response to the Valsalva maneuver in patients with HF can estimate PCWP and also detect changes within a single patient.
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usefulness of pulse amplitude changes during the valsalva maneuver measured using finger Photoplethysmography to identify elevated pulmonary capillary wedge pressure in patients with heart failure
American Journal of Cardiology, 2017Co-Authors: Nisha A Gilotra, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Kavita Sharma, Harry A SilberAbstract:The pulse amplitude ratio, the ratio of pulse pressure at the end of a Valsalva maneuver to before the onset of Valsalva, correlates with filling pressure. This study aimed to noninvasively estimate cardiac filling pressure in patients with heart failure. We developed a noninvasive handheld device to measure pulse amplitude ratio using finger Photoplethysmography. In 69 patients who underwent right heart catheterization, Photoplethysmography waveforms were recorded during a standardized Valsalva maneuver, and in 60 of these patients, pulse amplitude ratio was able to be calculated. Pulse amplitude ratio correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.58, p 15 mm Hg was statistically significant (p 15 mm Hg with 73% sensitivity and 77% specificity. Pulse amplitude ratio also increased by an average of 0.03 with a leg raise maneuver (p = 0.05, n = 36). In conclusion, we demonstrate that noninvasively measured response to the Valsalva maneuver in patients with HF can estimate PCWP and also detect changes within a single patient.
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assessing left ventricular filling pressure using finger Photoplethysmography during the valsalva maneuver predicts 30 day heart failure outcomes
Journal of the American College of Cardiology, 2016Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Saadia Rizvi, Steven P Schulman, Ryan J Tedford, Stuart D Russell, Harry A SilberAbstract:One reason for the high re-hospitalization rate for heart failure (HF) is the difficulty detecting elevated cardiac filling pressure after symptoms have improved. We showed that the amplitude of a finger Photoplethysmography waveform during a Valsalva maneuver relative to baseline (Pulse Amplitude
Nisha A Gilotra - One of the best experts on this subject based on the ideXlab platform.
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usefulness of noninvasively measured pulse amplitude changes during the valsalva maneuver to identify hospitalized heart failure patients at risk of 30 day heart failure events from the pressure hf study
American Journal of Cardiology, 2020Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Steven P Schulman, Ryan J Tedford, Stuart D Russell, Gayane Yenokyan, Harry A SilberAbstract:The pulse amplitude ratio (PAR), the ratio of pulse pressure at the end of the Valsalva maneuver to before the onset, correlates with cardiac filling pressure. We have developed a handheld device that uses finger Photoplethysmography to measure PAR and estimate left ventricular end diastolic pressure (LVEDP). Patients hospitalized with heart failure (HF) performed three 10-second trials of a standardized Valsalva maneuver (at 20 mm Hg measured via pressure transducer), while Photoplethysmography waveforms were recorded, at admission and discharge. Combined primary outcome was 30-day HF hospitalization, intravenous diuresis, or death. Fifty-two subjects had discharge PAR testing; 12 met the primary outcome. Median PAR on admission was 0.55 (interquartile range: 0.40 to 0.70, n = 48) and on discharge was 0.50 (interquartile range: 0.36 to 0.69). Mean PAR-estimated LVEDP was significantly higher in subjects that had an event (20.2 vs 16.9 mm Hg, p = 0.043). Subjects with PAR-estimated LVEDP >19.5 mm Hg had an event rate hazard ratio of 4.57 (95% confidence interval 1.37, 15.19, p = 0.013) compared with patients with LVEDP 19.5 mm Hg or below, with significantly lower 30-day event-free survival (log-rank p = 0.006). In conclusion, noninvasively estimated LVEDP using the pulse amplitude response to a Valsalva maneuver in patients hospitalized for HF changes with diuresis and identifies patients at high risk for 30-day HF events. Detection of elevated filling pressures before hospital discharge may be useful in guiding HF management to reduce HF events.
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usefulness of pulse amplitude changes during the valsalva maneuver measured using finger Photoplethysmography to identify elevated pulmonary capillary wedge pressure in patients with heart failure
American Journal of Cardiology, 2017Co-Authors: Nisha A Gilotra, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Kavita Sharma, Harry A SilberAbstract:The pulse amplitude ratio, the ratio of pulse pressure at the end of a Valsalva maneuver to before the onset of Valsalva, correlates with filling pressure. This study aimed to noninvasively estimate cardiac filling pressure in patients with heart failure. We developed a noninvasive handheld device to measure pulse amplitude ratio using finger Photoplethysmography. In 69 patients who underwent right heart catheterization, Photoplethysmography waveforms were recorded during a standardized Valsalva maneuver, and in 60 of these patients, pulse amplitude ratio was able to be calculated. Pulse amplitude ratio correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.58, p 2 of 0.54. Difference in mean pulse amplitude ratio for subjects with a PCWP ≤15 mm Hg versus >15 mm Hg was statistically significant (p ≥ 0.55 predicted PCWP > 15 mm Hg with 73% sensitivity and 77% specificity. Pulse amplitude ratio also increased by an average of 0.03 with a leg raise maneuver (p = 0.05, n = 36). In conclusion, we demonstrate that noninvasively measured response to the Valsalva maneuver in patients with HF can estimate PCWP and also detect changes within a single patient.
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usefulness of pulse amplitude changes during the valsalva maneuver measured using finger Photoplethysmography to identify elevated pulmonary capillary wedge pressure in patients with heart failure
American Journal of Cardiology, 2017Co-Authors: Nisha A Gilotra, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Kavita Sharma, Harry A SilberAbstract:The pulse amplitude ratio, the ratio of pulse pressure at the end of a Valsalva maneuver to before the onset of Valsalva, correlates with filling pressure. This study aimed to noninvasively estimate cardiac filling pressure in patients with heart failure. We developed a noninvasive handheld device to measure pulse amplitude ratio using finger Photoplethysmography. In 69 patients who underwent right heart catheterization, Photoplethysmography waveforms were recorded during a standardized Valsalva maneuver, and in 60 of these patients, pulse amplitude ratio was able to be calculated. Pulse amplitude ratio correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.58, p 15 mm Hg was statistically significant (p 15 mm Hg with 73% sensitivity and 77% specificity. Pulse amplitude ratio also increased by an average of 0.03 with a leg raise maneuver (p = 0.05, n = 36). In conclusion, we demonstrate that noninvasively measured response to the Valsalva maneuver in patients with HF can estimate PCWP and also detect changes within a single patient.
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assessing left ventricular filling pressure using finger Photoplethysmography during the valsalva maneuver predicts 30 day heart failure outcomes
Journal of the American College of Cardiology, 2016Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Saadia Rizvi, Steven P Schulman, Ryan J Tedford, Stuart D Russell, Harry A SilberAbstract:One reason for the high re-hospitalization rate for heart failure (HF) is the difficulty detecting elevated cardiac filling pressure after symptoms have improved. We showed that the amplitude of a finger Photoplethysmography waveform during a Valsalva maneuver relative to baseline (Pulse Amplitude
Ryan J Tedford - One of the best experts on this subject based on the ideXlab platform.
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usefulness of noninvasively measured pulse amplitude changes during the valsalva maneuver to identify hospitalized heart failure patients at risk of 30 day heart failure events from the pressure hf study
American Journal of Cardiology, 2020Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Steven P Schulman, Ryan J Tedford, Stuart D Russell, Gayane Yenokyan, Harry A SilberAbstract:The pulse amplitude ratio (PAR), the ratio of pulse pressure at the end of the Valsalva maneuver to before the onset, correlates with cardiac filling pressure. We have developed a handheld device that uses finger Photoplethysmography to measure PAR and estimate left ventricular end diastolic pressure (LVEDP). Patients hospitalized with heart failure (HF) performed three 10-second trials of a standardized Valsalva maneuver (at 20 mm Hg measured via pressure transducer), while Photoplethysmography waveforms were recorded, at admission and discharge. Combined primary outcome was 30-day HF hospitalization, intravenous diuresis, or death. Fifty-two subjects had discharge PAR testing; 12 met the primary outcome. Median PAR on admission was 0.55 (interquartile range: 0.40 to 0.70, n = 48) and on discharge was 0.50 (interquartile range: 0.36 to 0.69). Mean PAR-estimated LVEDP was significantly higher in subjects that had an event (20.2 vs 16.9 mm Hg, p = 0.043). Subjects with PAR-estimated LVEDP >19.5 mm Hg had an event rate hazard ratio of 4.57 (95% confidence interval 1.37, 15.19, p = 0.013) compared with patients with LVEDP 19.5 mm Hg or below, with significantly lower 30-day event-free survival (log-rank p = 0.006). In conclusion, noninvasively estimated LVEDP using the pulse amplitude response to a Valsalva maneuver in patients hospitalized for HF changes with diuresis and identifies patients at high risk for 30-day HF events. Detection of elevated filling pressures before hospital discharge may be useful in guiding HF management to reduce HF events.
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usefulness of pulse amplitude changes during the valsalva maneuver measured using finger Photoplethysmography to identify elevated pulmonary capillary wedge pressure in patients with heart failure
American Journal of Cardiology, 2017Co-Authors: Nisha A Gilotra, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Kavita Sharma, Harry A SilberAbstract:The pulse amplitude ratio, the ratio of pulse pressure at the end of a Valsalva maneuver to before the onset of Valsalva, correlates with filling pressure. This study aimed to noninvasively estimate cardiac filling pressure in patients with heart failure. We developed a noninvasive handheld device to measure pulse amplitude ratio using finger Photoplethysmography. In 69 patients who underwent right heart catheterization, Photoplethysmography waveforms were recorded during a standardized Valsalva maneuver, and in 60 of these patients, pulse amplitude ratio was able to be calculated. Pulse amplitude ratio correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.58, p 2 of 0.54. Difference in mean pulse amplitude ratio for subjects with a PCWP ≤15 mm Hg versus >15 mm Hg was statistically significant (p ≥ 0.55 predicted PCWP > 15 mm Hg with 73% sensitivity and 77% specificity. Pulse amplitude ratio also increased by an average of 0.03 with a leg raise maneuver (p = 0.05, n = 36). In conclusion, we demonstrate that noninvasively measured response to the Valsalva maneuver in patients with HF can estimate PCWP and also detect changes within a single patient.
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usefulness of pulse amplitude changes during the valsalva maneuver measured using finger Photoplethysmography to identify elevated pulmonary capillary wedge pressure in patients with heart failure
American Journal of Cardiology, 2017Co-Authors: Nisha A Gilotra, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Kavita Sharma, Harry A SilberAbstract:The pulse amplitude ratio, the ratio of pulse pressure at the end of a Valsalva maneuver to before the onset of Valsalva, correlates with filling pressure. This study aimed to noninvasively estimate cardiac filling pressure in patients with heart failure. We developed a noninvasive handheld device to measure pulse amplitude ratio using finger Photoplethysmography. In 69 patients who underwent right heart catheterization, Photoplethysmography waveforms were recorded during a standardized Valsalva maneuver, and in 60 of these patients, pulse amplitude ratio was able to be calculated. Pulse amplitude ratio correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.58, p 15 mm Hg was statistically significant (p 15 mm Hg with 73% sensitivity and 77% specificity. Pulse amplitude ratio also increased by an average of 0.03 with a leg raise maneuver (p = 0.05, n = 36). In conclusion, we demonstrate that noninvasively measured response to the Valsalva maneuver in patients with HF can estimate PCWP and also detect changes within a single patient.
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assessing left ventricular filling pressure using finger Photoplethysmography during the valsalva maneuver predicts 30 day heart failure outcomes
Journal of the American College of Cardiology, 2016Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Saadia Rizvi, Steven P Schulman, Ryan J Tedford, Stuart D Russell, Harry A SilberAbstract:One reason for the high re-hospitalization rate for heart failure (HF) is the difficulty detecting elevated cardiac filling pressure after symptoms have improved. We showed that the amplitude of a finger Photoplethysmography waveform during a Valsalva maneuver relative to baseline (Pulse Amplitude
Stuart D Russell - One of the best experts on this subject based on the ideXlab platform.
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usefulness of noninvasively measured pulse amplitude changes during the valsalva maneuver to identify hospitalized heart failure patients at risk of 30 day heart failure events from the pressure hf study
American Journal of Cardiology, 2020Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Steven P Schulman, Ryan J Tedford, Stuart D Russell, Gayane Yenokyan, Harry A SilberAbstract:The pulse amplitude ratio (PAR), the ratio of pulse pressure at the end of the Valsalva maneuver to before the onset, correlates with cardiac filling pressure. We have developed a handheld device that uses finger Photoplethysmography to measure PAR and estimate left ventricular end diastolic pressure (LVEDP). Patients hospitalized with heart failure (HF) performed three 10-second trials of a standardized Valsalva maneuver (at 20 mm Hg measured via pressure transducer), while Photoplethysmography waveforms were recorded, at admission and discharge. Combined primary outcome was 30-day HF hospitalization, intravenous diuresis, or death. Fifty-two subjects had discharge PAR testing; 12 met the primary outcome. Median PAR on admission was 0.55 (interquartile range: 0.40 to 0.70, n = 48) and on discharge was 0.50 (interquartile range: 0.36 to 0.69). Mean PAR-estimated LVEDP was significantly higher in subjects that had an event (20.2 vs 16.9 mm Hg, p = 0.043). Subjects with PAR-estimated LVEDP >19.5 mm Hg had an event rate hazard ratio of 4.57 (95% confidence interval 1.37, 15.19, p = 0.013) compared with patients with LVEDP 19.5 mm Hg or below, with significantly lower 30-day event-free survival (log-rank p = 0.006). In conclusion, noninvasively estimated LVEDP using the pulse amplitude response to a Valsalva maneuver in patients hospitalized for HF changes with diuresis and identifies patients at high risk for 30-day HF events. Detection of elevated filling pressures before hospital discharge may be useful in guiding HF management to reduce HF events.
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usefulness of pulse amplitude changes during the valsalva maneuver measured using finger Photoplethysmography to identify elevated pulmonary capillary wedge pressure in patients with heart failure
American Journal of Cardiology, 2017Co-Authors: Nisha A Gilotra, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Kavita Sharma, Harry A SilberAbstract:The pulse amplitude ratio, the ratio of pulse pressure at the end of a Valsalva maneuver to before the onset of Valsalva, correlates with filling pressure. This study aimed to noninvasively estimate cardiac filling pressure in patients with heart failure. We developed a noninvasive handheld device to measure pulse amplitude ratio using finger Photoplethysmography. In 69 patients who underwent right heart catheterization, Photoplethysmography waveforms were recorded during a standardized Valsalva maneuver, and in 60 of these patients, pulse amplitude ratio was able to be calculated. Pulse amplitude ratio correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.58, p 2 of 0.54. Difference in mean pulse amplitude ratio for subjects with a PCWP ≤15 mm Hg versus >15 mm Hg was statistically significant (p ≥ 0.55 predicted PCWP > 15 mm Hg with 73% sensitivity and 77% specificity. Pulse amplitude ratio also increased by an average of 0.03 with a leg raise maneuver (p = 0.05, n = 36). In conclusion, we demonstrate that noninvasively measured response to the Valsalva maneuver in patients with HF can estimate PCWP and also detect changes within a single patient.
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usefulness of pulse amplitude changes during the valsalva maneuver measured using finger Photoplethysmography to identify elevated pulmonary capillary wedge pressure in patients with heart failure
American Journal of Cardiology, 2017Co-Authors: Nisha A Gilotra, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Kavita Sharma, Harry A SilberAbstract:The pulse amplitude ratio, the ratio of pulse pressure at the end of a Valsalva maneuver to before the onset of Valsalva, correlates with filling pressure. This study aimed to noninvasively estimate cardiac filling pressure in patients with heart failure. We developed a noninvasive handheld device to measure pulse amplitude ratio using finger Photoplethysmography. In 69 patients who underwent right heart catheterization, Photoplethysmography waveforms were recorded during a standardized Valsalva maneuver, and in 60 of these patients, pulse amplitude ratio was able to be calculated. Pulse amplitude ratio correlated with pulmonary capillary wedge pressure (PCWP) (r = 0.58, p 15 mm Hg was statistically significant (p 15 mm Hg with 73% sensitivity and 77% specificity. Pulse amplitude ratio also increased by an average of 0.03 with a leg raise maneuver (p = 0.05, n = 36). In conclusion, we demonstrate that noninvasively measured response to the Valsalva maneuver in patients with HF can estimate PCWP and also detect changes within a single patient.
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assessing left ventricular filling pressure using finger Photoplethysmography during the valsalva maneuver predicts 30 day heart failure outcomes
Journal of the American College of Cardiology, 2016Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Saadia Rizvi, Steven P Schulman, Ryan J Tedford, Stuart D Russell, Harry A SilberAbstract:One reason for the high re-hospitalization rate for heart failure (HF) is the difficulty detecting elevated cardiac filling pressure after symptoms have improved. We showed that the amplitude of a finger Photoplethysmography waveform during a Valsalva maneuver relative to baseline (Pulse Amplitude
William R Herzog - One of the best experts on this subject based on the ideXlab platform.
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a noninvasive hand held device identifies elevated left ventricular filling pressure using finger Photoplethysmography during the valsalva maneuver
Journal of the American College of Cardiology, 2016Co-Authors: Panagis Galiatsatos, Theingi Tiffany Win, Jennifer Monti, Peter V Johnston, William R HerzogAbstract:The high rate of re-hospitalization for heart failure might be reduced by improving noninvasive techniques for identifying elevated left ventricular (LV) filling pressure. We showed that changes in a finger Photoplethysmography (PPG) waveform during the Valsalva maneuver (VM) reflect LV end-