Wedescribe a 62-year-old dilated cardiomyopathy patient in whomcongestive heart failure progressed shortly after DDDmodewas changed to VOOmode because of battery exhaustion. Emergency battery exchange with restoration of DDDmode improved his functional status to the previous level; pulmonary capillary wedge pressure decreased from 28 to 24 mmHgand cardiac output increased from 1.5 to 2.0 L/min ...

BACKGROUND Heart failure with preserved ejection fraction (HFPEF) is a common, globally recognised, form of heart failure for which no treatment has yet been shown to improve symptoms or prognosis. The pathophysiology of HFPEF is complex but characterised by increased left atrial pressure, especially during exertion, which might be a key therapeutic target. The rationale for the present study w...

Diastolic intraventricular pressure gradients (IVPGs) are a measure of the ability of the ventricle to facilitate its filling using diastolic suction. We assessed 15 healthy young but sedentary subjects, aged <50 yr (young subjects; age, 35 +/- 9 yr); 13 healthy but sedentary seniors, aged >65 yr with known reductions in ventricular compliance (elderly sedentary subjects; age, 70 +/- 4 yr); and...

The survival and ICU length of stay of 40 ARDS patients admitted to the ICU were analyzed to determine if a management strategy of lowering the pulmonary capillary wedge pressure (Ppw) was associated with an increased survival or a decreased ICU length of stay. ARDS was defined as three or four quadrant alveolar filling roentgenographically, a PaO2 less than 80 mm Hg with an FIO2 greater than ....

Acute respiratory distress syndrome (ARDS) is the clinical presentation of an acute pulmonary injury. It is pathologically represented by diffuse alveolar damage and pathophysiologically by development of acute non-cardiogenic pulmonary edema due to increased alveolar-capillary membrane permeability.(1,2) It may be due to pulmonary origin, such as diffused lung infection, gastric content aspira...

Background—Although several studies have demonstrated a good correlation between Doppler echocardiographic and invasive measurements of single hemodynamic variables, the accuracy of echocardiography in providing a comprehensive assessment in individual patients has not been validated. The aim of this study was to assess the accuracy and clinical applicability of Doppler echocardiography in dete...

D espite the progress that has been made in the field of pulmonary hypertension (PH) [1–3], there is no unifying and globally accepted definition of the condition. The first official haemodynamic definition of PH was proposed at the First World Symposium on Pulmonary Hypertension which took place 1973 in Geneva, Switzerland as a World Health Organization (WHO)-sponsored meeting [4]. This confer...

BACKGROUND AND PURPOSE Early goal-directed hemodynamic therapy is of particular importance for adequate cerebral circulation of patients with vasospasm after subarachnoid hemorrhage but is often precluded by the invasiveness of established cardiac output determination using a pulmonary artery catheter. This study was undertaken to validate the usefulness of less invasive goal-directed hemodynam...

Background—ACE inhibitors may not adequately suppress deleterious levels of angiotensin II in patients with heart failure. An angiotensin receptor blocker added to an ACE inhibitor may exert additional beneficial effects. Methods and Results—Eighty-three symptomatic stable patients with chronic heart failure receiving long-term ACE inhibitor therapy were randomly assigned to double-blind treatm...