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Esophageal assessments of left ventricular filling pressures: A proof-of-concept study
OBJECTIVE: We sought to evaluate if left ventricular filling pressures can be assessed from the esophagus. BACKGROUND: The invasive assessment of left ventricular filling pressures is of importance in the evaluation and monitoring of critically ill patients. The left atrium is in very close proximit...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982365/ https://www.ncbi.nlm.nih.gov/pubmed/24741493 http://dx.doi.org/10.4103/2229-5151.128008 |
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author | Meyer, Markus Bell, Stephen P Sardana, Neeraj Zubarik, Richard LeWinter, Martin M Dauerman, Harold L |
author_facet | Meyer, Markus Bell, Stephen P Sardana, Neeraj Zubarik, Richard LeWinter, Martin M Dauerman, Harold L |
author_sort | Meyer, Markus |
collection | PubMed |
description | OBJECTIVE: We sought to evaluate if left ventricular filling pressures can be assessed from the esophagus. BACKGROUND: The invasive assessment of left ventricular filling pressures is of importance in the evaluation and monitoring of critically ill patients. The left atrium is in very close proximity to the esophagus. We hypothesized that the temporal pressure decay characteristics of an esophageal fluid volume positioned at the level ofthe left atrium should depend on the atrial and left ventricular filling pressure. MATERIALS AND METHODS: In five pigs an esophageal balloon was placed at the level ofthe left atrium. The balloon was then pressurized to 50 mmHg followed by an automated release that allowed us to directly record the pressure decay, while simultaneously recording left atrial pressures. An algorithm was developed to estimate atrial pressures. We also tested if invasive transesophageal atrial pressures can be recorded via an ultrasound guided left atrial puncture. RESULTS: Noninvasive transesophageal assessments of left atrial pressures are feasible. The left atrial pressure directly affects the esophageal pressure decay and correlates with the transition point from an exponential pressure decay to a more linear decay (r = 0.949). This approach also allows for the assessment of atrial waveforms. We could also demonstrate that invasive transesophageal pressure measurements are feasible and safe. CONCLUSIONS: The esophagus allows for reproducible less invasive assessments of left ventricular filling pressures and atrial pressure waveforms. This close spatial relationship provides an alternative access site for diagnostic and therapeutic cardiac procedures. |
format | Online Article Text |
id | pubmed-3982365 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-39823652014-04-16 Esophageal assessments of left ventricular filling pressures: A proof-of-concept study Meyer, Markus Bell, Stephen P Sardana, Neeraj Zubarik, Richard LeWinter, Martin M Dauerman, Harold L Int J Crit Illn Inj Sci Original Article OBJECTIVE: We sought to evaluate if left ventricular filling pressures can be assessed from the esophagus. BACKGROUND: The invasive assessment of left ventricular filling pressures is of importance in the evaluation and monitoring of critically ill patients. The left atrium is in very close proximity to the esophagus. We hypothesized that the temporal pressure decay characteristics of an esophageal fluid volume positioned at the level ofthe left atrium should depend on the atrial and left ventricular filling pressure. MATERIALS AND METHODS: In five pigs an esophageal balloon was placed at the level ofthe left atrium. The balloon was then pressurized to 50 mmHg followed by an automated release that allowed us to directly record the pressure decay, while simultaneously recording left atrial pressures. An algorithm was developed to estimate atrial pressures. We also tested if invasive transesophageal atrial pressures can be recorded via an ultrasound guided left atrial puncture. RESULTS: Noninvasive transesophageal assessments of left atrial pressures are feasible. The left atrial pressure directly affects the esophageal pressure decay and correlates with the transition point from an exponential pressure decay to a more linear decay (r = 0.949). This approach also allows for the assessment of atrial waveforms. We could also demonstrate that invasive transesophageal pressure measurements are feasible and safe. CONCLUSIONS: The esophagus allows for reproducible less invasive assessments of left ventricular filling pressures and atrial pressure waveforms. This close spatial relationship provides an alternative access site for diagnostic and therapeutic cardiac procedures. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC3982365/ /pubmed/24741493 http://dx.doi.org/10.4103/2229-5151.128008 Text en Copyright: © International Journal of Critical Illness and Injury Science http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Meyer, Markus Bell, Stephen P Sardana, Neeraj Zubarik, Richard LeWinter, Martin M Dauerman, Harold L Esophageal assessments of left ventricular filling pressures: A proof-of-concept study |
title | Esophageal assessments of left ventricular filling pressures: A proof-of-concept study |
title_full | Esophageal assessments of left ventricular filling pressures: A proof-of-concept study |
title_fullStr | Esophageal assessments of left ventricular filling pressures: A proof-of-concept study |
title_full_unstemmed | Esophageal assessments of left ventricular filling pressures: A proof-of-concept study |
title_short | Esophageal assessments of left ventricular filling pressures: A proof-of-concept study |
title_sort | esophageal assessments of left ventricular filling pressures: a proof-of-concept study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982365/ https://www.ncbi.nlm.nih.gov/pubmed/24741493 http://dx.doi.org/10.4103/2229-5151.128008 |
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