Correlation of Exercise Right Heart Catheterization Hemodynamics in a Patient with an Implantable Hemodynamic Monitor
Author: Jeremy Slivnick
, MD, Additional authors**
Background:
In patients with heart failure (HF), the use of the implantable pulmonary artery (PA) sensors is associated with reduced HF hospitalizations. PA pressure sensor readings correlate well with right heart catheterization (RHC) at rest. We report a pilot case of an exercise RHC with simultaneous readings from a CardioMEMS PA sensor.
Case:
A 56-year-old female with a history of chronic obstructive pulmonary disease (COPD) and diastolic HF with prior PA sensor implant was evaluated for worsening exertional dyspnea. PA sensor readings demonstrated normal resting PA pressures. Given her symptoms, an exercise RHC was performed to assess for exercise-induced diastolic dysfunction. PA pressures were obtained simultaneously from her PA sensor and RHC rest and with exertion.
Results/Outcome:
At rest, PA pressure by RHC and PA sensor was 23/10 mmHg (mean 16 mmHg) and 19/10 mmHg (mean 12 mmHg) respectively. Peak exercise occurred at 20 Watts (55 RPM) on supine ergometer. At peak exercise, PA pressures by RHC and PA sensor were 36/10 mmHg (mean 27 mmHg) and 40/6 mmHg (mean 22 mmHg) respectively. Given her low filling pressures with exercise, exercise-induced diastolic dysfunction was ruled out and COPD was felt to be responsible for her symptoms.
Discussion:
In our patient, PA pressures during exercise were similar between RHC and PA sensor. Further evaluation with an expanded patient cohort is recommended. If true, the use of implantable PA pressures sensors could offer a non-invasive means of assessing exercise hemodynamics in patients with a device.
**Authors
Jeremy Slivnick, MD – The Ohio State University Wexner Medical Center
Sitaramesh Emani, MD – The Ohio State University Wexner Medical Center
Laura Yamokowski, BSN, RN – The Ohio State University Wexner Medical Center
Philip Binkley, MD – The Ohio State University Wexner Medical Center
Richard Gumina MD, PhD – The Ohio State University Wexner Medical Center
Program Director: Scott Maffett, MD, FACC
Program Coordinator: Monica Rios
