Abstract
Objective—To develop a complete system for the measurement, recording, and analysis of ambulatory pulmonary artery pressure.
Design—The new system consists of a pulmonary artery catheter, an ambulatory recorder, and a desktop computer. Pulmonary artery pressure is measured by a micromanometer tipped catheter with an in vivo calibration system to allow correction for zero drift. This catheter is plugged into a small battery powered recorder. The recorder has two input channels, one for pressure and one for an event marker. The pressure wave is sampled 32 times/s, processed by an in built computer, compressed, and stored in semiconductor memory. On completion of a recording, data is transferred from the ambulatory recorder through a serial data link to an Acorn Archimedes desktop computer on which further data processing, statistical analysis, graphics, and printouts can be obtained.
Results—The system has been used in 18 patients, with technically successful recording in 14, less than 15 minutes of data loss in three, and 12 hours of data loss in one.
Conclusions—A new system for ambulatory pulmonary artery monitoring has been developed and used clinically with success. It may provide new perspectives on the pathophysiology of disease as it applies to everyday life.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BRADLEY R. D. DIAGNOSTIC RIGHT-HEART CATHETERISATION WITH MINIATURE CATHETERS IN SEVERELY ILL PATIENTS. Lancet. 1964 Oct 31;2(7366):941–942. doi: 10.1016/s0140-6736(64)90869-4. [DOI] [PubMed] [Google Scholar]
 - Cournand A., Riley R. L., Breed E. S., Baldwin E. D., Richards D. W., Lester M. S., Jones M. MEASUREMENT OF CARDIAC OUTPUT IN MAN USING THE TECHNIQUE OF CATHETERIZATION OF THE RIGHT AURICLE OR VENTRICLE. J Clin Invest. 1945 Jan;24(1):106–116. doi: 10.1172/JCI101570. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Dexter L., Haynes F. W., Burwell C. S., Eppinger E. C., Sagerson R. P., Evans J. M. STUDIES OF CONGENITAL HEART DISEASE. II. THE PRESSURE AND OXYGEN CONTENT OF BLOOD IN THE RIGHT AURICLE, RIGHT VENTRICLE, AND PULMONARY ARTERY IN CONTROL PATIENTS, WITH OBSERVATIONS ON THE OXYGEN SATURATION AND SOURCE OF PULMONARY "CAPILLARY" BLOOD. J Clin Invest. 1947 May;26(3):554–560. doi: 10.1172/JCI101840. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - FIFE W. P., LEE B. S. CONSTRUCTION AND USE OF SELF-GUIDING, RIGHT HEART AND PULMONARY ARTERY CATHETER. J Appl Physiol. 1965 Jan;20:148–149. doi: 10.1152/jappl.1965.20.1.148. [DOI] [PubMed] [Google Scholar]
 - Falicov R. E., Resnekov L. Relationship of the pulmonary artery end-diastolic pressure to the left ventricular end-diastolic and mean filling pressures in patients with and without left ventricular dysfunction. Circulation. 1970 Jul;42(1):65–73. doi: 10.1161/01.cir.42.1.65. [DOI] [PubMed] [Google Scholar]
 - Gibbs J. S., Cunningham D., Shapiro L. M., Park A., Poole-Wilson P. A., Fox K. M. Diurnal variation of pulmonary artery pressure in chronic heart failure. Br Heart J. 1989 Jul;62(1):30–35. doi: 10.1136/hrt.62.1.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Gibbs J. S., Cunningham D., Sparrow J., Poole-Wilson P. A., Fox K. M. Unpredictable zero drift in intravascular micromanometer tipped catheters during long term pulmonary artery pressure recording: implications for catheter design. Cardiovasc Res. 1989 Feb;23(2):152–158. doi: 10.1093/cvr/23.2.152. [DOI] [PubMed] [Google Scholar]
 - Gibbs J. S., Ferrari R., Keegan J., Ceconi C., Wright C., Fox K. M., Poole-Wilson P. A. The influence of right heart catheterisation on pulmonary arterial pressure in chronic heart failure: relationship to neuroendocrinal changes. Int J Cardiol. 1991 Dec;33(3):365–376. doi: 10.1016/0167-5273(91)90065-w. [DOI] [PubMed] [Google Scholar]
 - Gibbs J. S., Keegan J., Wright C., Fox K. M., Poole-Wilson P. A. Pulmonary artery pressure changes during exercise and daily activities in chronic heart failure. J Am Coll Cardiol. 1990 Jan;15(1):52–61. doi: 10.1016/0735-1097(90)90174-n. [DOI] [PubMed] [Google Scholar]
 - Ikram H., Richards A. M., Hamilton E. J., Nicholls M. G. Continuous recording of pulmonary artery pressure in unrestricted subjects. Br Heart J. 1984 Apr;51(4):421–426. doi: 10.1136/hrt.51.4.421. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Jenkins B. S., Bradley R. D., Branthwaite M. A. Evaluation of pulmonary arterial end-diastolic pressure as an indirect estimate of left atrial mean pressure. Circulation. 1970 Jul;42(1):75–78. doi: 10.1161/01.cir.42.1.75. [DOI] [PubMed] [Google Scholar]
 - Levy R. D., Cunningham D., Shapiro L. M., Wright C., Mockus L., Fox K. M. Continuous ambulatory pulmonary artery pressure monitoring. A new method using a transducer tipped catheter and a simple recording system. Br Heart J. 1986 Apr;55(4):336–343. doi: 10.1136/hrt.55.4.336. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Levy R. D., Cunningham D., Shapiro L. M., Wright C., Mockus L., Fox K. M. Diurnal variation in left ventricular function: a study of patients with myocardial ischaemia, syndrome X, and of normal controls. Br Heart J. 1987 Feb;57(2):148–153. doi: 10.1136/hrt.57.2.148. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Levy R. D., Shapiro L. M., Wright C., Mockus L. J., Fox K. M. The haemodynamic response to myocardial ischaemia in ambulant patients with variant angina. Br Heart J. 1986 Dec;56(6):518–525. doi: 10.1136/hrt.56.6.518. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Levy R. D., Shapiro L. M., Wright C., Mockus L. J., Fox K. M. The haemodynamic significance of asymptomatic ST segment depression assessed by ambulatory pulmonary artery pressure monitoring. Br Heart J. 1986 Dec;56(6):526–530. doi: 10.1136/hrt.56.6.526. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Levy R. D., Shapiro L. M., Wright C., Mockus L., Fox K. M. Haemodynamic response to myocardial ischaemia during unrestricted activity, exercise testing, and atrial pacing assessed by ambulatory pulmonary artery pressure monitoring. Br Heart J. 1986 Jul;56(1):12–18. doi: 10.1136/hrt.56.1.12. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Levy R. D., Shapiro L. M., Wright C., Mockus L., Fox K. M. Syndrome X: the haemodynamic significance of ST segment depression. Br Heart J. 1986 Oct;56(4):353–357. doi: 10.1136/hrt.56.4.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - McMichael J., Sharpey-Schafer E. P. CARDIAC OUTPUT IN MAN BY A DIRECT FICK METHOD: Effects of Posture, Venous Pressure Change, Atropine, And Adrenaline. Br Heart J. 1944 Jan;6(1):33–40. doi: 10.1136/hrt.6.1.33. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Nathan A. W., Perry S. G., Cochrane T., Banim S. O., Spurrell R. A., Camm A. J. Ambulatory monitoring of pulmonary artery pressure. A preliminary clinical evaluation. Br Heart J. 1983 Jan;49(1):33–37. doi: 10.1136/hrt.49.1.33. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Richards A. M., Ikram H., Crozier I. G., Nicholls M. G., Jans S. Ambulatory pulmonary arterial pressure in primary pulmonary hypertension: variability, relation to systemic arterial pressure, and plasma catecholamines. Br Heart J. 1990 Feb;63(2):103–108. doi: 10.1136/hrt.63.2.103. [DOI] [PMC free article] [PubMed] [Google Scholar]
 - Swan H. J., Ganz W., Forrester J., Marcus H., Diamond G., Chonette D. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med. 1970 Aug 27;283(9):447–451. doi: 10.1056/NEJM197008272830902. [DOI] [PubMed] [Google Scholar]
 - WERKO L., VARNAUSKAS E., ELIASCH H., LAGERLOF H., SENNING A., THOMASSON B. Further evidence that the pulmonary capillary venous pressure pulse in man reflects cyclic pressure changes in the left atrium. Circ Res. 1953 Jul;1(4):337–339. doi: 10.1161/01.res.1.4.337. [DOI] [PubMed] [Google Scholar]
 
