Abstract 12812: The Use of Hemodynamics Does Not Aide in Correctly Identifying the Etiology of Cardiomyopathy in Patients Receiving Advanced Therapy

• Published in: Circulation (New York, N.Y.) Vol. 142; no. Suppl_3 Suppl 3; p. A12812
• Main Authors: Aiad, Norman, Narula, Navneet, Gidea, Claudia G, Katz, Stuart D, Rao, Shaline, Reyentovich, Alex, Saraon, Tajinderpal S, Smith, Deane, Moazami, Nader, Pan, Stephen
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 17.11.2020
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.12812

IntroductionThere is limited evidence demonstrating the benefit of hemodynamics in diagnosing the etiology of cardiomyopathy in patients referred for advanced therapies such as left ventricular assist device (LVAD) or orthotropic heart transplantation (OHT).HypothesisIn patients with end stage heart failure, invasive hemodynamic measures differ between patients with different etiologies of cardiomyopathy.MethodsHemodynamic and echocardiography data from 119 patients undergoing LVAD (n=85, Male 76%, Age 63 ± 12 years) or OHT (n=34, Male 70%, Age 60 ± 11 years) at a single center was reviewed. The follow invasive hemodynamic measurements were recorded and compared (central venous pressure (CVP), Pulmonary Artery Pulsatility Index (PAPI), peripheral vascular resistance (PVR), transpulmonary gradient, mean pulmonary artery pressure, cardiac index, and pulmonary diastolic pressure decoupling) were compared between groups.ResultsBetween patients with dilated cardiomyopathy (DCM), ischemic cardiomyopathy (ICM), and those with missed diagnosis, there were no significant differences between CVP, PAPI, PVR, transpulmonary gradient, mean PA pressure, cardiac index, or decoupling (Table 1). Left ventricular end diastolic diameter (LVEDD) on echocardiography was significantly larger in patients with DCM when compared to those with ischemic cardiomyopathy as well as infiltrative cardiomyopathies (6.65±1.04mm, 6.24±0.77mm, and 5.14±1.25mm, respectively p<0.0001).ConclusionsHemodynamic measures in patients with stage D cardiomyopathy did not differ according to the etiology of the underlying cardiomyopathy. . The similarity in hemodynamic profiles amongst different cardiomyopathy subtypes likely reflects end stage disease. LVEDD performed better than hemodynamics to help differentiate cardiomyopathy etiologies, and in addition were helpful in identifying cases where the diagnosis was incorrect.