Comparison of invasive and non-invasive measurements of haemodynamic parameters in patients with advanced heart failure

Aim Measurement of haemodynamic parameters using a Swan-Ganz catheter is of clinical importance in patients with advanced heart failure; however, its applicability is limited due to its invasiveness. The aim of the study was to estimate the concordance between invasive and non-invasive measurements of haemodynamic parameters in patients with advanced heart failure. Methods and results We examined 25 patients with advanced heart failure (20 men, age: 64+/-11 years, New York Heart Association class III/IV: 88/12%, left ventricular ejection fraction: 37+/-20%), 13 (52%) demonstrated decompensated heart failure. Resting haemodynamic parameters were measured simultaneously using two methods: an invasive Swan-Ganz catheterization and a thermodilution technique; and a non-invasive recording using a device for finger arterial pressure waveform analysis. The following parameters were analysed: stroke volume (SV, ml), cardiac output (CO, l/min) and systemic vascular resistance (SVR, dyne x s/cm(5)). The concordance between these two methods was assessed using the variability coefficient calculated according to a Bland-Altman method. Comparing the invasive and non-invasive measures, variability coefficients were: 13, 18 and 11% for SV, SVR and CO, respectively. Similar variability coefficients were obtained when invasive and non-invasive measurements were compared in prespecified subgroups of patients, distinguished based on the presence of decompensation, atrial fibrillation and values of SBP. Conclusions Evaluation of haemodynamic parameters using a non-invasive method based on a pressure pulse contour model reveals an adequate concordance with the measures obtained using an invasive approach. Our results suggest that a non-invasive method for haemodynamic monitoring could be applied in clinical practice in patients with advanced heart failure.