{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T01:03:33Z","timestamp":1789434213556,"version":"build-2803163510"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":82,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Left ventricular (LV) contractility is a core characterization of cardiac function that provides therapeutic guidance in both chronic and acute patient care. Measurement of the change in pressure over time in the left ventricle (LV dP\/dt) is a clinical gold standard for evaluating cardiac contractility but is invasive and has associated risks. Measurement of dP\/dt from a radial arterial pressure catheter offers a less invasive and safer alternative. Studies comparing these two measurements are limited and have conflicting conclusions. The objective of this study was to evaluate the correlations between LV and radial arterial dP\/dt and clarify the clinical utility of radial dP\/dt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective observational study carried out at a large tertiary academic medical center. Data was collected from the electronic medical records of patients who underwent transcatheter aortic valve replacement (TAVR) with an Edwards Acumen IQ transducer attached to the radial arterial catheter to measure dP\/dt. Concurrent measurements of dP\/dt were recorded from LV and radial arterial catheters before and after TAVR. Comparisons included Bland-Altman analysis, concordance changes following TAVR, Spearman correlations and linear regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Bland-Altman analysis before TAVR demonstrated a bias between LV and radial measurements of 621\u2009\u00b1\u2009396 mmHg\/s with 95% limits of agreement from \u2212\u2009155 to 1397 mmHg\/s. After TAVR, the bias decreased to 54\u2009\u00b1\u2009412 mmHg\/s, with 95% limits of agreement from \u2212\u2009754 to 862 mmHg\/s. Concordance analysis of the changes following TAVR demonstrated an inverse relationship with a decrease in LV dP\/dt and an increase in radial dP\/dt observed in 73% of the patients. Correlation analysis before TAVR revealed Spearman\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.16 (95% CI: -0.06,0.37). After TAVR there was no significant change in the correlation coefficient, Spearman\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.09 (95% CI: -0.14, 0.31), but the slope of the best-fit regression line increased from 0.48 (95% CI: 0.44, 0.53) to 0.88 (95%CI: 0.80, 0.97).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe aortic stenosis impacts the relationship between LV and radial measurements of dP\/dt. Following TAVR the correlation remains poor, but linear regression analysis suggests radial measurement of dP\/dt may have the clinical utility to characterize directional changes of contractility within an individual patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Clinical trial Number: not applicable. The study protocol was reviewed by the institutional human subjects research committee, which waived the need for written, informed consent. As a quality improvement project designed to evaluate the clinical utility of radial arterial dP\/dt measurement it was not registered on the ClinicalTrials.gov website.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-026-06159-z","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T03:44:54Z","timestamp":1782359094000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radial arterial versus left ventricular dP\/dt for assessment of contractility in patients undergoing transcatheter aortic valve replacement: a retrospective observational study"],"prefix":"10.1186","volume":"26","author":[{"given":"Steven","family":"Garcia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellie","family":"Tsang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal W.","family":"Fleming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"issue":"1","key":"6159_CR1","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/0002-9149(69)90005-8","volume":"44","author":"DT Mason","year":"1971","unstructured":"Mason DT, Braunwald E, Covell JW, Sonnenblick EH, Ross J Jr. Assessment of cardiac contractility. The relation between the rate of pressure rise and ventricular pressure during isovolumic systole. Circulation. 1971;44(1):47\u201358. https:\/\/doi.org\/10.1016\/0002-9149(69)90005-8.","journal-title":"Circulation"},{"issue":"2","key":"6159_CR2","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.vascn.2012.05.009","volume":"66","author":"RD Sarazan","year":"2012","unstructured":"Sarazan RD, Kroehle JP, Main BW. Left ventricular pressure, contractility and dP\/dt(max) in nonclinical drug safety assessment studies. J Pharmacol Toxicol Methods. 2012;66(2):71\u20138. https:\/\/doi.org\/10.1016\/j.vascn.2012.05.009.","journal-title":"J Pharmacol Toxicol Methods"},{"key":"6159_CR3","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/1471-2261-12-13","volume":"12","author":"P Morimont","year":"2012","unstructured":"Morimont P, Lambermont B, Desaive T, et al. Arterial dP\/dtmax accurately reflects left ventricular contractility during shock when adequate vascular filling is achieved. BMC Cardiovasc Disord. 2012;12:13. https:\/\/doi.org\/10.1186\/1471-2261-12-13.","journal-title":"BMC Cardiovasc Disord"},{"key":"6159_CR4","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1186\/s13054-018-2260-1","volume":"22","author":"M Monge Garcia","year":"2018","unstructured":"Monge Garcia M, Jian Z, Settels JJ, et al. Performance comparison of ventricular and arterial dP\/dtmax for assessing left ventricular systolic function during different experimental loading and contractile conditions. Crit Care. 2018;22:325. https:\/\/doi.org\/10.1186\/s13054-018-2260-1.","journal-title":"Crit Care"},{"issue":"4","key":"6159_CR5","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1111\/j.1365-2362.2007.01784.x","volume":"37","author":"JE Sharman","year":"2007","unstructured":"Sharman JE, Qasem AM, Hanekom L, Gill DS, Lim R, Marwick TH. Radial pressure waveform dP\/dt max is a poor indicator of left ventricular systolic function. Eur J Clin Invest. 2007;37(4):276\u201381. https:\/\/doi.org\/10.1111\/j.1365-2362.2007.01784.x.","journal-title":"Eur J Clin Invest"},{"issue":"2","key":"6159_CR6","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1161\/01.cir.53.2.293","volume":"53","author":"MA Quinones","year":"1976","unstructured":"Quinones MA, Gaasch WH, Alexander JK. Influence of acute changes in preload, afterload, contractile state and heart rate on ejection and isovolumic indices of myocardial contractility in man. Circulation. 1976;53(2):293\u2013302. https:\/\/doi.org\/10.1161\/01.cir.53.2.293.","journal-title":"Circulation"},{"key":"6159_CR7","unstructured":"Pagel PS, Boettcher BT, Tawil JN, Freed JK, . In: Kaplan JA, Augoustides JGT, Maus T, Mittnacht AJC, Pagel PS, Ramakrishna H, editors. Kaplan\u2019s Cardiac Anesthesia: Perioperative and Critical Care. 8th ed. Philadelphia: Elsevier; 2024. p. 137."},{"issue":"4","key":"6159_CR8","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1016\/0002-9149(69)90005-8","volume":"23","author":"DT Mason","year":"1969","unstructured":"Mason DT. Usefulness and limitations of the rate of rise of intraventricular pressure (dp-dt) in the evaluation of myocardial contractility in man. Am J Cardiol. 1969;23(4):516\u201327. https:\/\/doi.org\/10.1016\/0002-9149(69)90005-8.","journal-title":"Am J Cardiol"},{"issue":"2","key":"6159_CR9","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.vascn.2012.01.001","volume":"66","author":"RL Hamlin","year":"2012","unstructured":"Hamlin RL, del Rio C. dP\/dt(max)--a measure of \u2018baroinometry\u2019. J Pharmacol Toxicol Methods. 2012;66(2):63\u20135. https:\/\/doi.org\/10.1016\/j.vascn.2012.01.001.","journal-title":"J Pharmacol Toxicol Methods"},{"issue":"6","key":"6159_CR10","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1161\/01.cir.49.6.1088","volume":"49","author":"KL Peterson","year":"1974","unstructured":"Peterson KL, Skloven D, Ludbrook P, Uther JB, Ross J Jr. Comparison of isovolumic and ejection phase indices of myocardial performance in man. Circulation. 1974;49(6):1088\u2013101. https:\/\/doi.org\/10.1161\/01.cir.49.6.1088.","journal-title":"Circulation"},{"issue":"4","key":"6159_CR11","doi-asserted-by":"publisher","first-page":"H1874","DOI":"10.1152\/ajpheart.00754.2004","volume":"288","author":"D Garcia","year":"2005","unstructured":"Garcia D, Barenbrug PJ, Pibarot P, Dekker AL, van der Veen FH, Maessen JG, Dumesnil JG, Durand LG. A ventricular-vascular coupling model in presence of aortic stenosis. Am J Physiol Heart Circ Physiol. 2005;288(4):H1874\u201384. https:\/\/doi.org\/10.1152\/ajpheart.00754.2004.","journal-title":"Am J Physiol Heart Circ Physiol"},{"issue":"3","key":"6159_CR12","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1053\/j.jvca.2005.11.006","volume":"20","author":"SG De Hert","year":"2006","unstructured":"De Hert SG, Robert D, Cromheecke S, Michard F, Nijs J, Rodrigus IE. Evaluation of left ventricular function in anesthetized patients using femoral artery dP\/dt(max). J Cardiothorac Vasc Anesth. 2006;20(3):325\u201330. https:\/\/doi.org\/10.1053\/j.jvca.2005.11.006.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"5","key":"6159_CR13","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.ejheart.2006.11.005","volume":"9","author":"JM Tartiere","year":"2007","unstructured":"Tartiere JM, Logeart D, Beauvais F, Chavelas C, Kesri L, Tabet JY, Cohen-Solal A. Non-invasive radial pulse wave assessment for the evaluation of left ventricular systolic performance in heart failure. Eur J Heart Fail. 2007;9(5):477\u201383. https:\/\/doi.org\/10.1016\/j.ejheart.2006.11.005.","journal-title":"Eur J Heart Fail"},{"key":"6159_CR14","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1186\/s13054-019-2654-8","volume":"23","author":"P Ostadal","year":"2019","unstructured":"Ostadal P, Vondrakova D, Kr\u00fcger A, et al. Continual measurement of arterial dP\/dtmax enables minimally invasive monitoring of left ventricular contractility in patients with acute heart failure. Crit Care. 2019;23:364. https:\/\/doi.org\/10.1186\/s13054-019-2654-8.","journal-title":"Crit Care"},{"issue":"5","key":"6159_CR15","doi-asserted-by":"publisher","first-page":"1934","DOI":"10.21037\/jtd-19-3161","volume":"12","author":"H Guo","year":"2020","unstructured":"Guo H, Zhou J, Wang Z, Liu LK, Yu SZ, Cai HW. The role of the maximal first derivative of the radial pulse wave (Rad dP\/dtmax) in monitoring cardiac function. J Thorac Dis. 2020;12(5):1934\u201341. https:\/\/doi.org\/10.21037\/jtd-19-3161.","journal-title":"J Thorac Dis"},{"issue":"6","key":"6159_CR16","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1007\/s00134-013-2861-8","volume":"39","author":"S Scolletta","year":"2013","unstructured":"Scolletta S, Bodson L, Donadello K, Taccone FS, Devigili A, Vincent JL, De Backer D. Assessment of left ventricular function by pulse wave analysis in critically ill patients. Intensive Care Med. 2013;39(6):1025\u201333. https:\/\/doi.org\/10.1007\/s00134-013-2861-8.","journal-title":"Intensive Care Med"},{"issue":"38","key":"6159_CR17","doi-asserted-by":"publisher","first-page":"105786","DOI":"10.1016\/j.jaccas.2025.105786","volume":"30","author":"KN Kapadia","year":"2025","unstructured":"Kapadia KN, Chow N, Mcwhorter YS. Using dP\/dt Contour Analysis to Wean IABP\/Inotropic Support in a Cardiogenic Shock Patient. JACC Case Rep. 2025;30(38):105786. https:\/\/doi.org\/10.1016\/j.jaccas.2025.105786.","journal-title":"JACC Case Rep"},{"issue":"2","key":"6159_CR18","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.ccep.2021.12.002","volume":"14","author":"MK Elliott","year":"2022","unstructured":"Elliott MK, Mehta VS, Rinaldi CA. Pacing Optimized by Left Ventricular dP\/dtmax. Card Electrophysiol Clin. 2022;14(2):223\u201332. https:\/\/doi.org\/10.1016\/j.ccep.2021.12.002.","journal-title":"Card Electrophysiol Clin"},{"issue":"1","key":"6159_CR19","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/s13613-019-0537-4","volume":"9","author":"S Vaquer","year":"2019","unstructured":"Vaquer S, Chemla D, Teboul JL, Ahmad U, Cipriani F, Oliva JC, Ochagavia A, Artigas A, Baigorri F, Monnet X. Influence of changes in ventricular systolic function and loading conditions on pulse contour analysis-derived femoral dP\/dtmax. Ann Intensive Care. 2019;9(1):61. https:\/\/doi.org\/10.1186\/s13613-019-0537-4.","journal-title":"Ann Intensive Care"},{"key":"6159_CR20","doi-asserted-by":"publisher","unstructured":"Carrara M, Campitelli R, Guberti D, Monge Garcia MI, Ferrario M. The role of pulse wave analysis indexes for critically ill patients: a narrative review. Physiol Meas. 2024;45(8). https:\/\/doi.org\/10.1088\/1361-6579\/ad6acf.","DOI":"10.1088\/1361-6579\/ad6acf"},{"issue":"1","key":"6159_CR21","doi-asserted-by":"publisher","first-page":"8948","DOI":"10.1038\/s41598-023-31987-w","volume":"13","author":"L Garber","year":"2023","unstructured":"Garber L, Khodaei S, Maftoon N, Keshavarz-Motamed Z. Impact of TAVR on coronary artery hemodynamics using clinical measurements and image-based patient-specific in silico modeling. Sci Rep. 2023;13(1):8948. https:\/\/doi.org\/10.1038\/s41598-023-31987-w.","journal-title":"Sci Rep"},{"key":"6159_CR22","doi-asserted-by":"publisher","first-page":"112","DOI":"10.3389\/fgene.2015.00112","volume":"6","author":"JC Kohn","year":"2015","unstructured":"Kohn JC, Lampi MC, Reinhart-King CA. Age-related vascular stiffening: causes and consequences. Front Genet. 2015;6:112. https:\/\/doi.org\/10.3389\/fgene.2015.00112. Published 2015 Mar 30.","journal-title":"Front Genet"},{"issue":"7","key":"6159_CR23","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1161\/CIRCRESAHA.121.318061","volume":"128","author":"P Boutouyrie","year":"2021","unstructured":"Boutouyrie P, Chowienczyk P, Humphrey JD, Mitchell GF. Arterial Stiffness and Cardiovascular Risk in Hypertension. Circ Res. 2021;128(7):864\u201386. https:\/\/doi.org\/10.1161\/CIRCRESAHA.121.318061.","journal-title":"Circ Res"},{"issue":"5","key":"6159_CR24","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1080\/24748706.2021.1944708","volume":"5","author":"BA Carabello","year":"2021","unstructured":"Carabello BA. The Pathophysiology of Afterload Mismatch and Ventricular Hypertrophy. Struct Heart. 2021;5(5):446\u201356. https:\/\/doi.org\/10.1080\/24748706.2021.1944708.","journal-title":"Struct Heart"},{"issue":"18","key":"6159_CR25","doi-asserted-by":"publisher","first-page":"2190","DOI":"10.1016\/j.jcin.2020.04.008","volume":"13","author":"MY Yin","year":"2020","unstructured":"Yin MY, Tandar A, Sharma V, Glotzbach JP, Shah RU, Dranow E, Tseliou E, Fang JC, Drakos SG, Welt FGP. Left Ventricular Hemodynamic Changes During Transcatheter Aortic Valve Replacement Assessed by Real-Time Pressure-Volume Loops. JACC Cardiovasc Interv. 2020;13(18):2190\u20132. https:\/\/doi.org\/10.1016\/j.jcin.2020.04.008.","journal-title":"JACC Cardiovasc Interv"},{"issue":"11","key":"6159_CR26","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1016\/j.cardfail.2025.08.011","volume":"31","author":"AJM van den Enden","year":"2025","unstructured":"van den Enden AJM, van den Dorpel MMP, Mondellini GM, Adrichem R, Mattace-Raso AM, Barros Bastos M, Schreuder JJ, Lenzen MJ, Kardys I, Geleijnse ML, Nuis RJ, Daemen J, Meuwese CL, Burkhoff D, Van Mieghem NM. Immediate Effects of Transcatheter Aortic Valve Replacement on Left Ventricular Cardiac Mechanics in Moderate Aortic Stenosis: A Case Series With In Vivo Pressure-Volume Reconstructions. J Card Fail. 2025;31(11):1754\u20138. https:\/\/doi.org\/10.1016\/j.cardfail.2025.08.011.","journal-title":"J Card Fail"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-026-06159-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-026-06159-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-026-06159-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:07:51Z","timestamp":1789430871000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12872-026-06159-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6159"],"URL":"https:\/\/doi.org\/10.1186\/s12872-026-06159-z","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"assertion":[{"value":"20 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was reviewed by the University of California, Davis Institutional Review Board for human subjects research, which waived the need for written, informed consent. As a quality improvement project designed to evaluate the clinical utility of radial arterial dP\/dt measurement it was not registered on the ClinicalTrials.gov website. Clinical trial Number: not applicable. The study adhered to all guidelines presented in the Declaration of Helsinki Ethical Principles for Medical Research involving Human Participants.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Neal W Fleming, MD, PhD: has supported contracted research for Rostrum Medical innovations, Masimo, Inc. and Edwards LifeSciences. He has received funds from Merck Pharmaceuticals for investigator-initiated research. He has received honoraria from Edwards LifeSciences (B-D Critical Care) for invited presentations. Steven Garcia, MD, Ellie Tsang, BS, Jacqueline Chen, MD: No competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"798"}}