Background: Pressure–volume loops (PVLs) can provide valuable information about left ventricular (LV) contractility and loading conditions. Acquiring PVLs in real time during high-risk percutaneous coronary intervention (HR-PCI) may improve our understanding of procedural haemodynamic changes and the impact of haemodynamic support devices.
Hypothesis: We sought to examine the feasibility and utility of PVL analysis in assessing changes in LV contractility and loading conditions during HR-PCI performed with and without Impella mechanical circulatory support (MCS).
Methods: We enrolled nine patients who underwent HR-PCI at two tertiary centres. Six patients had Impella CP device support. LV pressures and volumes were measured with a conductance catheter at different device flow levels and at key timepoints during the procedure. PVLs were analysed to detect changes in LV contractility and loading conditions.
Conclusion: During HR-PCI, good-quality PVL acquisition and analysis was feasible, even in patients with Impella support. PVLs can detect real-time changes in LV contractility and loading conditions, including changes related to different procedural manoeuvres (e.g. balloon inflations). PVL analysis can improve our understanding of the haemodynamic changes during HR-PCI and potentially guide appropriate MCS device selection for patients who require a supported HR-PCI.