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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 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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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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abstract 10905 Pulse Amplitude changes during the valsalva maneuver measured using finger photoplethysmography identify elevated pulmonary capillary wedge pressure in heart failure patients
Circulation, 2015Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Saadia Rizvi, Harry A SilberAbstract:Introduction: Pulse Amplitude ratio (PAR) (ratio of Pulse pressure at end of Valsalva maneuver (VM) to before onset) correlates with filling pressure. We developed a noninvasive device to measure P...
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 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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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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abstract 10905 Pulse Amplitude changes during the valsalva maneuver measured using finger photoplethysmography identify elevated pulmonary capillary wedge pressure in heart failure patients
Circulation, 2015Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Saadia Rizvi, Harry A SilberAbstract:Introduction: Pulse Amplitude ratio (PAR) (ratio of Pulse pressure at end of Valsalva maneuver (VM) to before onset) correlates with filling pressure. We developed a noninvasive device to measure P...
Klara Kastovska - One of the best experts on this subject based on the ideXlab platform.
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seasonal and diel changes in photosynthetic activity of the snow alga chlamydomonas nivalis chlorophyceae from svalbard determined by Pulse Amplitude modulation fluorometry
FEMS Microbiology Ecology, 2007Co-Authors: Marek Stibal, Josef Elster, Marie Sabacka, Klara KastovskaAbstract:The seasonal and diel dynamics of the physiological state and photosynthetic activity of the snow alga Chlamydomonas nivalis were investigated in a snowfield in Svalbard. The snow surface represents an environment with very high irradiation intensities along with stable low temperatures close to freezing point. Photosynthetic activity was measured using Pulse Amplitude modulation fluorometry. Three types of cell (green biflagellate vegetative cells, orange spores clustered by means of mucilaginous sheaths, and purple spores with thick cell walls) were found, all of them photosynthetically active. The pH of snow ranged between 5.0 and 7.5, and the conductivity ranged between 5 and 75 μS cm−1. The temperature of snow was stable (−0.1 to +0.1°C), and the incident radiation values ranged from 11 to 1500 μmol photons m−2 s−1. The photosynthetic activity had seasonal and diel dynamics. The F v/ F m values ranged between 0.4 and 0.7, and generally declined over the course of the season. A dynamic response of F v/ F m to the irradiance was recorded. According to the saturating photon fluence values E k, the algae may have obtained saturating light as deep as 3 cm in the snow when there were higher-light conditions, whereas they were undersaturated at prevalent low light even if on the surface.
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seasonal and diel changes in photosynthetic activity of the snow alga chlamydomonas nivalis chlorophyceae from svalbard determined by Pulse Amplitude modulation fluorometry
FEMS Microbiology Ecology, 2007Co-Authors: Marek Stibal, Josef Elster, Marie Sabacka, Klara KastovskaAbstract:The seasonal and diel dynamics of the physiological state and photosynthetic activity of the snow alga Chlamydomonas nivalis were investigated in a snowfield in Svalbard. The snow surface represents an environment with very high irradiation intensities along with stable low temperatures close to freezing point. Photosynthetic activity was measured using Pulse Amplitude modulation fluorometry. Three types of cell (green biflagellate vegetative cells, orange spores clustered by means of mucilaginous sheaths, and purple spores with thick cell walls) were found, all of them photosynthetically active. The pH of snow ranged between 5.0 and 7.5, and the conductivity ranged between 5 and 75 μS cm−1. The temperature of snow was stable (−0.1 to +0.1°C), and the incident radiation values ranged from 11 to 1500 μmol photons m−2 s−1. The photosynthetic activity had seasonal and diel dynamics. The F v/ F m values ranged between 0.4 and 0.7, and generally declined over the course of the season. A dynamic response of F v/ F m to the irradiance was recorded. According to the saturating photon fluence values E k, the algae may have obtained saturating light as deep as 3 cm in the snow when there were higher-light conditions, whereas they were undersaturated at prevalent low light even if on the surface.
Gayane Yenokyan - 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 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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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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abstract 10905 Pulse Amplitude changes during the valsalva maneuver measured using finger photoplethysmography identify elevated pulmonary capillary wedge pressure in heart failure patients
Circulation, 2015Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Saadia Rizvi, Harry A SilberAbstract:Introduction: Pulse Amplitude ratio (PAR) (ratio of Pulse pressure at end of Valsalva maneuver (VM) to before onset) correlates with filling pressure. We developed a noninvasive device to measure P...
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 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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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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abstract 10905 Pulse Amplitude changes during the valsalva maneuver measured using finger photoplethysmography identify elevated pulmonary capillary wedge pressure in heart failure patients
Circulation, 2015Co-Authors: Nisha A Gilotra, Brett L Wanamaker, Hussein Rahim, Katherine Kunkel, Ryan J Tedford, Stuart D Russell, Ilan S Wittstein, Gayane Yenokyan, Saadia Rizvi, Harry A SilberAbstract:Introduction: Pulse Amplitude ratio (PAR) (ratio of Pulse pressure at end of Valsalva maneuver (VM) to before onset) correlates with filling pressure. We developed a noninvasive device to measure P...
