Changes in inferior vena cava area represent a more sensitive metric than changes in filling pressures during experimental manipulation of intravascular volume and tone

Aims Remote monitoring of pulmonary artery pressure has reduced heart failure (HF) hospitalizations in chronic HF as elevation of pulmonary artery pressure provides information that can guide treatment. The venous system is characterized by high capacitance, thus substantial increases in intravascul...

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Published in:European journal of heart failure 2022-03, Vol.24 (3), p.455-462
Main Authors: Ivey‐Miranda, Juan B., Wetterling, Friedrich, Gaul, Robert, Sheridan, Stephen, Asher, Jennifer L., Rao, Veena S., Maulion, Christopher, Mahoney, Devin, Mebazaa, Alexandre, Gray, Alastair P., Burkhoff, Daniel, Cowie, Martin R., Cox, Zachary L., Butler, Javed, Fudim, Marat, McDonald, Kenneth, Damman, Kevin, Borlaug, Barry A., Testani, Jeffrey M.
Format: Article
Language:English
Subjects:
Animal
Animals
Assessment of Congestion
Cardiac Catheterization
Central Venous Pressure
Heart Diseases
Heart Failure
Humans
Inferior vena cava
Sheep
Vena Cava, Inferior - diagnostic imaging
Venous pressure
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Summary:Aims Remote monitoring of pulmonary artery pressure has reduced heart failure (HF) hospitalizations in chronic HF as elevation of pulmonary artery pressure provides information that can guide treatment. The venous system is characterized by high capacitance, thus substantial increases in intravascular volume can occur before filling pressures increase. The inferior vena cava (IVC) is a highly compliant venous conduit and thus a candidate for early detection of change in intravascular volume. We aimed to compare IVC cross‐sectional area using a novel sensor with cardiac filling pressures during experimental manipulation of volume status, vascular tone, and cardiac function. Methods and results Experiments were conducted in sheep to manipulate volume status (colloid infusion), vascular tone (nitroglycerin infusion) and cardiac function (rapid cardiac pacing). A wireless implantable IVC sensor was validated ex‐vivo and in‐vivo, and then used to measure the cross‐sectional area of the IVC. Right‐ and left‐sided cardiac filling pressures were obtained via right heart catheterization. The IVC sensor provided highly accurate and precise measurements of cross‐sectional area in ex‐vivo and in‐vivo validation. IVC area changes were more sensitive than the corresponding changes in cardiac filling pressures during colloid infusion (p 
ISSN:1388-9842
1879-0844
DOI:10.1002/ejhf.2395