Monitoring of heart failure: comparison of left atrial pressure with intrathoracic impedance and natriuretic peptide measurements in an experimental model of ovine heart failure

• DOI: 10.1042/cs20100388
• Publication Date: 2010-09-17T13:22:36Z
• Authors: Miriam T. Rademaker; Christopher J. Ch...; Iain C. Melton; A. Mark Richards; Christopher M. Fr...; Jeff Siou; Fujian Qu; Neal L. Eigler; Dan Gutfinger; Richard W. Troughton
• Keywords: Atrial natriuretic peptide; Left atrial pressure; Ventricular pressure

Monitoring of HF (heart failure) with intracardiac pressure, intrathoracic impedance and/or natriuretic peptide levels has been advocated. We aimed to investigate possible differences in the response patterns each these monitoring modalities during decompensation that may have an impact on potential for early therapeutic intervention. Six sheep were implanted a LAP (left atrial pressure) sensor and CRT-D (cardiac resynchronization therapy defibrillator) capable along six lead configuration vectors. An estimate ALAP (LAP from admittance) was determined by linear regression. induced rapid ventricular pacing at 180 220 bpm (beats/min) week each, followed third daily suspensions increasing durations (1–5 h). Incremental progressively severe reflected increases (5.9 ± 0.4 24.5 1.6 mmHg) plasma (20 3 197 36 pmol/l) B-type (3.7 0.7 32.7 5.4 (all P<0.001) levels. All vectors decreased proportion severity P<0.001), LVring ventricular)-case vector correlating best (r2=0.63, P<0.001). Natriuretic peptides closely paralleled acute changes alterations (P<0.001), whereas delayed relative LAP. exhibited good agreement In summary, measured LV correlates significantly LAP, but exhibits alterations. respond rapidly changes. Direct measurements all show promise as indicators worsening HF. provides be clinically useful.