ArticleAmerican heart journal2008
Pulmonary vascular input impedance is a combined measure of pulmonary vascular resistance and stiffness and predicts clinical outcomes better than pulmonary vascular resistance alone in pediatric patients with pulmonary hypertension.
Article in American heart journal, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers.
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Who cites it
88 citing papers in PubMed.
- Dissecting contributions of pulmonary arterial remodeling to right ventricular afterload in pulmonary hypertension.Bioengineering & translational medicine · 2025Article
- Pulmonary Impedance and Wave Reflections in Adults with Mitral Stenosis: Immediate and Follow-Up Effects of Balloon Valvuloplasty.Annals of biomedical engineering · 2025Article
- Hybrid physics-based and data-driven modeling of vascular bifurcation pressure differences.Computers in biology and medicine · 2025Article
- Feasibility of a Composite Measure of Pulmonary Vascular Impedance and Application to Patients with Chronic RV Failure Post LVAD Implant.Cardiovascular engineering and technology · 2024Article
- Characterization of pulmonary arterial stiffness using cardiac MRI.The international journal of cardiovascular imaging · 2024Review
- Beyond CFD: Emerging methodologies for predictive simulation in cardiovascular health and disease.Biophysics reviews · 2023Review
- A Comprehensive Assessment of Right Ventricular Function in Chronic Thromboembolic Pulmonary Hypertension.Journal of clinical medicine · 2022Review
- Computational modelling of multi-temporal ventricular-vascular interactions during the progression of pulmonary arterial hypertension.Journal of the Royal Society, Interface · 2022Article
- The physiological basis of pulmonary arterial hypertension.The European respiratory journal · 2022Review
- Hemodynamically Unloading the Distal Pulmonary Circulation in Pulmonary Hypertension: A Modeling Study.Journal of biomechanical engineering · 2022Article
- Clinical application of pulmonary vascular resistance in patients with pulmonary arterial hypertension.Journal of cardiothoracic surgery · 2021Review
- Metalloproteinases and their inhibitors are associated with pulmonary arterial stiffness and ventricular function in pediatric pulmonary hypertension.American journal of physiology. Heart and circulatory physiology · 2021Article
- Inverse modeling framework for characterizing patient-specific microstructural changes in the pulmonary arteries.Journal of the mechanical behavior of biomedical materials · 2021Article
- Changes in the Pulmonary Artery Wave Reflection in Dogs with Experimentally-Induced Acute Pulmonary Embolism and the Effect of Vasodilator.Animals : an open access journal from MDPI · 2021Article
- Arterial load and right ventricular-vascular coupling in pulmonary hypertension.Journal of applied physiology (Bethesda, Md. : 1985) · 2021Article
- Semi-Automated Graphical System for Calculating Pulmonary Vascular Impedances in a Clinical Setting.IEEE open journal of engineering in medicine and biology · 2021Article
- Mechanical forces and metabolic changes cooperate to drive cellular memory and endothelial phenotypes.Current topics in membranes · 2021Review
- Reconstruction of the Swine Pulmonary Artery Using a Graft Engineered With Syngeneic Cardiac Pericytes.Frontiers in bioengineering and biotechnology · 2021Article
- Exogenous Estrogen Preserves Distal Pulmonary Arterial Mechanics and Prevents Pulmonary Hypertension in Rats.American journal of respiratory and critical care medicine · 2020Article
- Proximal pulmonary vascular stiffness as a prognostic factor in children with pulmonary arterial hypertension.European heart journal. Cardiovascular Imaging · 2019Article
28 more citing papers are in PubMed but not listed here.
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8 authors.
Funding
Abstract
backgroundPulmonary vascular resistance (PVR) is the current standard for evaluating reactivity in children with pulmonary arterial hypertension (PAH). However, PVR measures only the mean component of right ventricular afterload and neglects pulsatile effects. We recently developed and validated a method to measure pulmonary vascular input impedance, which revealed excellent correlation between the zero harmonic impedance value and PVR and suggested a correlation between higher-harmonic impedance values and pulmonary vascular stiffness. Here we show that input impedance can be measured routinely and easily in the catheterization laboratory, that impedance provides PVR and pulmonary vascular stiffness from a single measurement, and that impedance is a better predictor of disease outcomes compared with PVR.
methodsPressure and velocity waveforms within the main pulmonary artery were measured during right heart catheterization of patients with normal pulmonary artery hemodynamics (n = 14) and those with PAH undergoing reactivity evaluation (49 subjects, 95 conditions). A correction factor needed to transform velocity into flow was obtained by calibrating against cardiac output. Input impedance was obtained off-line by dividing Fourier-transformed pressure and flow waveforms.
resultsExceptional correlation was found between the indexed zero harmonic of impedance and indexed PVR (y = 1.095x + 1.381, R2 = 0.9620). In addition, the modulus sum of the first 2 harmonics of impedance was found to best correlate with indexed pulse pressure over stroke volume (y = 13.39x - 0.8058, R2 = 0.7962). Among a subset of patients with PAH (n = 25), cumulative logistic regression between outcomes to total indexed impedance was better (R(L)2 = 0.4012) than between outcomes and indexed PVR (R(L)2 = 0.3131).
conclusionsInput impedance can be consistently and easily obtained from pulse-wave Doppler and a single catheter pressure measurement, provides comprehensive characterization of the main components of RV afterload, and better predicts patient outcomes compared with PVR alone.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.