Abstract 16567: Validity and Reliability of a Novel Slow Cuff-Deflation System for Non-Invasive Blood Pressure Monitoring in Patients with Continuous-Flow Left Ventricular Assist Device (CF-LVAD)
Background Non-invasive BP measurements are difficult to obtain in CF-LVAD pts due to diminished pulse pressure. We tested Terumo’s Elemano BP Monitor (which has a unique slow cuff-deflation setting to enhance sensitivity) vs A-line (gold standard) and vs Doppler ultrasound (current clinical standard) in CF-LVAD pts.
Methods BP was obtained in 60 HeartMate II pts (30 in-pts and 30 out-pts). BP was measured in triplicate on two occasions (≥2 days apart) using Doppler and Terumo in all pts. A-line data were available for comparison in 30 in-pts who had their 1st set of BP measurements in the CTICU. To assess within device reproducibility, the mean absolute difference (MAD) between the 2nd and 3rd readings was computed. For between device reproducibility, we computed the mean of the 2nd and 3rd BP measurements for each pt and then calculated MAD and correlation coefficients between devices.
Results Out of 254 BP reading attempts the success rates for Doppler and Terumo were 100% and 91%. MAD for SBP, DBP and MAP between the 2nd and 3rd Terumo measures were 4.6±0.6, 5.1±0.7, and 4.2±0.6 mmHg; Doppler was 2.9±0.2 mmHg. In the CTICU pts, MAD between A-line SBP and Terumo SBP was 5.8±0.9mmHg; MAD between A-line SBP and Doppler was 6.3±1.8mmHg. Correlations between A-line SBP and Terumo SBP and between A-line MAP and Terumo MAP were 0.82 and 0.74 (all p<0.0001); correlations between A-line SBP and Doppler and between A-line MAP and Doppler were 0.79 and 0.64 (all p<0.001). Average A-line, Doppler and Terumo BPs in CTICU pts are shown in the figure. Overall (in-pts and out-pts), correlations between Doppler and Terumo SBP and between Doppler and Terumo MAP were 0.85 and 0.75 (all p<0.0001).
Conclusion Terumo BP Monitor appears successful, reproducible and valid when compared to A-line and Doppler. This small and automated device may enable home BP monitoring, allowing cardiologists to optimize treatment over the phone, preventing unnecessary clinic visits.
- Ventricular assist devices
- Heart failure
- Blood pressure
- New technology
- Artificial heart/Cardiac support devices
- © 2012 by American Heart Association, Inc.