{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:13:19Z","timestamp":1788775999643,"version":"build-2803163510"},"reference-count":13,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003010","name":"Ege University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003010","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/02eaafc18","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Cardiovasc. Dev. Dis.","JCDD"],"abstract":"<jats:p>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\u2019s rho, Wilcoxon signed-rank test, and Bland\u2013Altman analysis were applied. Results: Median invasive MAP was 73.0 [IQR 66\u201380] mmHg and median Doppler pressure was 75.0 [IQR 70\u201380] mmHg. Doppler measurements demonstrated strong-to-excellent correlation with invasive MAP across all time points (r = 0.78\u20130.91, p &lt; 0.001), with no significant paired differences (all p &gt; 0.05). Bland\u2013Altman analysis revealed a bias of \u22120.35 mmHg with limits of agreement of \u22129.10 to +8.40 mmHg, within the accepted \u00b110 mmHg threshold. Correlation with systolic pressure was lower (r = 0.66\u20130.89, p &lt; 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.<\/jats:p>","DOI":"10.3390\/jcdd13060276","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:33:54Z","timestamp":1781768034000},"page":"276","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Evaluation of Doppler Blood Pressure Measurement in Continuous-Flow LVAD Patients: Implications for Postoperative Management"],"prefix":"10.3390","volume":"13","author":[{"given":"Umit","family":"Kahraman","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Emrah","family":"Oguz","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Vusali","family":"Kasumovi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"software","vocabulary":"credit"}]},{"given":"Aysen Yaprak","family":"Kapkin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4424-2880","authenticated-orcid":false,"given":"Ahmet","family":"Daylan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Serkan","family":"Ertugay","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"given":"Sanem","family":"Nalbantgil","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Cagatay","family":"Engin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0259-0799","authenticated-orcid":false,"given":"Mustafa","family":"Ozbaran","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6282-2489","authenticated-orcid":false,"given":"Tahir","family":"Yagdi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1016\/j.athoracsur.2010.04.093","article-title":"Infectious complications in patients with left ventricular assist device: Etiology and outcomes in the continuous-flow era","volume":"90","author":"Topkara","year":"2010","journal-title":"Ann. Thorac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s11906-017-0782-6","article-title":"The unique blood pressures and pulsatility of LVAD patients: Current challenges and future opportunities","volume":"19","author":"Castagna","year":"2017","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.healun.2018.11.003","article-title":"Prognostic implications of serial outpatient blood pressure measurements in patients with an axial continuous-flow left ventricular assist device","volume":"38","author":"Pinsino","year":"2019","journal-title":"J. Heart Lung Transplant."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e000074","DOI":"10.1161\/HHF.0000000000000074","article-title":"Management of hypertension in patients with ventricular assist devices: A scientific statement from the American Heart Association","volume":"15","author":"Eisen","year":"2022","journal-title":"Circ. Heart Fail."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1470320320966445","DOI":"10.1177\/1470320320966445","article-title":"The role of renin-angiotensin system in patients with left ventricular assist devices","volume":"21","author":"Briasoulis","year":"2020","journal-title":"J. Renin-Angiotensin-Aldosterone Syst."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1161\/CIRCHEARTFAILURE.114.002000","article-title":"Blood pressure and adverse events during continuous-flow LVAD support","volume":"8","author":"Saeed","year":"2015","journal-title":"Circ. Heart Fail."},{"key":"ref_7","first-page":"1170","article-title":"Outcomes based on blood pressure in patients on continuous flow left ventricular assist device support: An Interagency Registry for Mechanically Assisted Circulatory Support analysis","volume":"38","author":"Cowger","year":"2019","journal-title":"J. Heart Lung Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/j.jchf.2018.05.012","article-title":"HVAD: The ENDURANCE Supplemental Trial","volume":"6","author":"Milano","year":"2018","journal-title":"JACC Heart Fail."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.healun.2024.04.065","article-title":"An ISHLT consensus statement on strategies to prevent and manage hemocompatibility related adverse events in patients with a durable, continuous-flow ventricular assist device","volume":"43","author":"Hollis","year":"2024","journal-title":"J. Hear. Lung Transplant."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.healun.2013.12.001","article-title":"An analysis of pump thrombus events in patients in the HeartWare ADVANCE bridge to transplant and continued access protocol trial","volume":"33","author":"Najjar","year":"2014","journal-title":"J. Heart Lung Transplant."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1002\/ehf2.12456","article-title":"Accuracy of Doppler blood pressure measurement in continuous-flow LVAD patients","volume":"6","author":"Li","year":"2019","journal-title":"ESC Heart Fail."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/MAT.0000000000000805","article-title":"Noninvasive measures of pulsatility and BP during continuous-flow LVAD support","volume":"65","author":"Rangasamy","year":"2019","journal-title":"ASAIO J."},{"key":"ref_13","unstructured":"Yaron, D.B., Scott, C.S., Mani, A.D., and Daniel, J.G. (2024). The VAD coordinator\u2019s role: Education and team communication. Textbook of Transplantation and Mechanical Support for End-Stage Heart and Lung Disease, Wiley-Blackwell."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/6\/276\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:03:37Z","timestamp":1788775417000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/6\/276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,18]]},"references-count":13,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcdd13060276"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13060276","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,18]]}}}