TY - JOUR
T1 - Clinically significant change in stroke volume in pulmonary hypertension
AU - Van Wolferen, Serge A.
AU - Van De Veerdonk, Marielle C.
AU - Mauritz, Gert Jan
AU - Jacobs, Wouter
AU - Marcus, J. Tim
AU - Marques, Koen M.J.
AU - Bronzwaer, Jean G.F.
AU - Heymans, Martijn W.
AU - Boonstra, Anco
AU - Postmus, Pieter E.
AU - Westerhof, Nico
AU - Vonk Noordegraaf, Anton
AU - Heijmans, M.W.
N1 - Funding Information: Funding/Support: This work was financially supported by the Department of Pulmonary Disease, VU University Medical Center, Amsterdam, The Netherlands.
PY - 2011/5/1
Y1 - 2011/5/1
N2 - Background: Stroke volume is probably the best hemodynamic parameter because it reflects therapeutic changes and contains prognostic information in pulmonary hypertension (PH). Stroke volume directly reflects right ventricular function in response to its load, without the correction of compensatory increased heart rate as is the case for cardiac output. For this reason, stroke volume, which can be measured noninvasively, is an important hemodynamic parameter to monitor during treatment. However, the extent of change in stroke volume that constitutes a clinically significant change is unknown. The aim of this study was to determine the minimal important difference (MID) in stroke volume in PH. Methods: One hundred eleven patients were evaluated at baseline and after 1 year of follow-up with a 6-min walk test (6MWT) and cardiac MRI. Using the anchor-based method with 6MWT as the anchor, and the distribution-based method, the MID of stroke volume change could be determined. Results: After 1 year of treatment, there was, on average, a significant increase in stroke volume and 6MWT. The change in stroke volume was related to the change in 6MWT. Using the anchor-based method, an MID of 10 mL in stroke volume was calculated. The distribution-based method resulted in an MID of 8 to 12 mL. Conclusions: Both methods showed that a 10-mL change in stroke volume during follow-up should be considered as clinically relevant. This value can be used to interpret changes in stroke volume during clinical follow-up in PH.
AB - Background: Stroke volume is probably the best hemodynamic parameter because it reflects therapeutic changes and contains prognostic information in pulmonary hypertension (PH). Stroke volume directly reflects right ventricular function in response to its load, without the correction of compensatory increased heart rate as is the case for cardiac output. For this reason, stroke volume, which can be measured noninvasively, is an important hemodynamic parameter to monitor during treatment. However, the extent of change in stroke volume that constitutes a clinically significant change is unknown. The aim of this study was to determine the minimal important difference (MID) in stroke volume in PH. Methods: One hundred eleven patients were evaluated at baseline and after 1 year of follow-up with a 6-min walk test (6MWT) and cardiac MRI. Using the anchor-based method with 6MWT as the anchor, and the distribution-based method, the MID of stroke volume change could be determined. Results: After 1 year of treatment, there was, on average, a significant increase in stroke volume and 6MWT. The change in stroke volume was related to the change in 6MWT. Using the anchor-based method, an MID of 10 mL in stroke volume was calculated. The distribution-based method resulted in an MID of 8 to 12 mL. Conclusions: Both methods showed that a 10-mL change in stroke volume during follow-up should be considered as clinically relevant. This value can be used to interpret changes in stroke volume during clinical follow-up in PH.
UR - http://www.scopus.com/inward/record.url?scp=79955779573&partnerID=8YFLogxK
U2 - https://doi.org/10.1378/chest.10-1066
DO - https://doi.org/10.1378/chest.10-1066
M3 - Article
C2 - 20864614
SN - 0012-3692
VL - 139
SP - 1003
EP - 1009
JO - Chest
JF - Chest
IS - 5
ER -