Clinical Evaluation of Doppler Blood Pressure Measurement in Continuous-Flow LVAD Patients: Implications for Postoperative Management
Makaleler > Tam Makale · 2026
Yazarlar: Ümit KAHRAMAN, Emrah OĞUZ, VUSALI KASUMOVI, Ayşen Yaprak KAPKIN, AHMET DAYLAN, Serkan ERTUGAY, Sanem NALBANTGİL, Çağatay ENGİN, Mustafa ÖZBARAN, Tahir YAĞDI
Journal of Cardiovascular Development and Disease, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2026, cilt 13, ss 276-276
DOI: 10.3390/jcdd13060276
Özet
Background: Continuous-flow left ventricular assist devices (LVADs) generate non-pulsatile circulation, rendering conventional oscillometric blood pressure measurements unreliable. Accurate monitoring is critical to prevent complications including stroke, pump thrombosis, and aortic regurgitation. Doppler-based measurement is widely used as a non-invasive alternative, yet its accuracy relative to invasive arterial pressure remains insufficiently characterized. Methods: In this prospective single-centre study, 32 adult continuous-flow LVAD patients underwent simultaneous invasive radial artery and Doppler blood pressure measurements twice daily over three consecutive days (192 paired readings; Day 3: n = 27 due to technical recording issues). Pulsatility was assessed by means of peripheral pulse palpation and transthoracic echocardiography. Spearman’s rho, Wilcoxon signed-rank test, and Bland–Altman analysis were applied. Results: Median invasive MAP was 73.0 [IQR 66–80] mmHg and median Doppler pressure was 75.0 [IQR 70–80] mmHg. Doppler measurements demonstrated strong-to-excellent correlation with invasive MAP across all time points (r = 0.78–0.91, p < 0.001), with no significant paired differences (all p > 0.05). Bland–Altman analysis revealed a bias of −0.35 mmHg with limits of agreement of −9.10 to +8.40 mmHg, within the accepted ±10 mmHg threshold. Correlation with systolic pressure was lower (r = 0.66–0.89, p < 0.001), with a positive bias of +13.47 mmHg and wide limits of agreement (+1.28 to +25.67 mmHg), indicating clinically unacceptable agreement. Conclusions: Doppler-derived blood pressure may provide a reliable estimate of invasive MAP in continuous-flow LVAD patients, whereas its utility for systolic pressure estimation appears limited. Doppler measurement represents a practical, non-invasive tool for routine MAP monitoring in both inpatient and outpatient settings.