{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T05:04:50Z","timestamp":1777093490348,"version":"3.51.4"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>A cohort of heart failure (HF) patients receiving left ventricular assist devices (LVADs) has decoupling of their diastolic pulmonary artery pressure and pulmonary capillary wedge pressure. However, the clinical implications of this decoupling remain unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results:<\/jats:title>\n            <jats:p>\n              In this prospective study, patients with LVADs underwent routine invasive hemodynamic ramp testing with right heart catheterization, during which LVAD speeds were adjusted. Inappropriate decoupling was defined as a &gt;5 mm\u2009Hg difference between diastolic pulmonary artery pressure and pulmonary capillary wedge pressure. The primary outcomes of survival and heart failure readmission rates after ramp testing were assessed. Among 63 LVAD patients (60\u00b112 years old and 25 female [40%]), 27 patients (43%) had inappropriate decoupling at their baseline speed. After adjustment of their rotation speed during ramp testing, 30 patients (48%) had inappropriate decoupling. Uni\/multivariable Cox analyses demonstrated that decoupling was the only significant predictor for the composite end point of death and heart failure readmission during the 1 year following the ramp study (total of 18 events; hazards ratio, 1.09; 95% confidence interval, 1.04\u20131.24;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05). Furthermore, normalization of decoupling (n=8) during ramp testing was significantly associated with higher 1-year heart failure readmission\u2013free survival rate compared with the non-normalized group (n=19, 100% versus 53%;\n              <jats:italic>P<\/jats:italic>\n              =0.035).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The presence of inappropriate decoupling was associated with worse outcomes in patients with LVADs. Prospective, large-scale multicenter studies to validate the result are warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.117.003882","type":"journal-article","created":{"date-parts":[[2017,9,15]],"date-time":"2017-09-15T01:20:17Z","timestamp":1505438417000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["Decoupling Between Diastolic Pulmonary Artery Pressure and Pulmonary Capillary Wedge Pressure as a Prognostic Factor After Continuous Flow Ventricular Assist Device Implantation"],"prefix":"10.1161","volume":"10","author":[{"given":"Teruhiko","family":"Imamura","sequence":"first","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Chung","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Nguyen","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Rodgers","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Sayer","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sirtaz","family":"Adatya","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitasha","family":"Sarswat","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gene","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayant","family":"Raikhelkar","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeyohi","family":"Ota","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae","family":"Song","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen","family":"Juricek","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktoriya","family":"Kagan","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valluvan","family":"Jeevanandam","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mandeep","family":"Mehra","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Burkhoff","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nir","family":"Uriel","sequence":"additional","affiliation":[{"name":"From the Department of Medicine (T.I., B.C., A.N., D.R., G.S., S.A., N.S., G.K., J.R., N.U.) and Department of Surgery (T.O., T.S., C.J., V.K., V.J.), University of Chicago Medical Center, IL; Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (M.M.); and Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (D.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.10.003"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909938"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.075"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2016.1208557"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.10.001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv317"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.08.022"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rce.2016.04.002"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.11.008"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-1653"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11897-016-0288-6"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.108.796789"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/1755-5922.12111"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.04.014"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60101-3"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.06.323"}],"container-title":["Circulation: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCHEARTFAILURE.117.003882","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:21:06Z","timestamp":1715563266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCHEARTFAILURE.117.003882"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9]]},"references-count":16,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1161\/CIRCHEARTFAILURE.117.003882"],"URL":"https:\/\/doi.org\/10.1161\/circheartfailure.117.003882","relation":{},"ISSN":["1941-3289","1941-3297"],"issn-type":[{"value":"1941-3289","type":"print"},{"value":"1941-3297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9]]},"assertion":[{"value":"2017-01-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-09-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e003882"}}