Table 3

Mean Echocardiographic Measurements for Each Stage of the Ramp Protocol

Stage IStage IIStage IIIStage IVStage V
HeartMate II
 Median pump speed, RPM8,0008,8009,60010,40011,200
 Flow, l/min4 ± 15 ± 15 ± 16 ± 16 ± 1
 PI6 ± 16 ± 15 ± 14 ± 13 ± 1
 Power, W4 ± 15 ± 16 ± 17 ± 19 ± 1
 CI, l/min/m22 ± 12 ± 12 ± 13 ± 13 ± 2
 RAP, mm Hg12 ± 811 ± 711 ± 810 ± 711 ± 6
 Systolic PAP, mm Hg43 ± 1141 ± 1339 ± 1336 ± 1234 ± 10
 Diastolic PAP, mm Hg23 ± 821 ± 1020 ± 918 ± 917 ± 9
 Mean PAP, mm Hg29 ± 928 ± 1127 ± 1024 ± 923 ± 9
 PCWP, mm Hg21 ± 1017 ± 814 ± 811 ± 611 ± 5
 PA saturation, %56 ± 959 ± 962 ± 865 ± 768 ± 7
 BP, Doppler, mm Hg87 ± 2091 ± 1896 ± 17100 ± 1999 ± 19
 LV EDD, cm6.6 ± 1.46.2 ± 1.56.0 ± 1.55.6 ± 1.75.1 ± 1.8
 % Reduction in LV EDD0 ± 0−8 ± 6−11 ± 8−14 ± 10−27 ± 16
 % With AV opening533722127
 LV EDV, ml320 ± 133302 ± 139263 ± 138253 ± 129184 ± 129
 LV conicity0.73 ± 0.030.74 ± 0.040.76 ± 0.040.77 ± 0.030.79 ± 0.04
 LV sphericity0.72 ± 0.070.71 ± 0.070.67 ± 0.060.66 ± 0.050.62 ± 0.07
 RV EDV, ml248 ± 116281 ± 124277 ± 124325 ± 118349 ± 147
 RV septal curvature0.97 ± 0.111.00 ± 0.111.03 ± 0.130.98 ± 0.141.02 ± 0.11
 RV free-wall curvature1.22 ± 0.071.20 ± 0.061.19 ± 0.051.20 ± 0.061.19 ± 0.04
HVAD
 Median pump speed, rpm2,3002,5002,7002,9003,150
 Flow, l/min3 ± 14 ± 14 ± 14 ± 15 ± 1
 PI4 ± 14 ± 13 ± 13 ± 13 ± 1
 Power, W2 ± 03 ± 04 ± 05 ± 06 ± 1
 CI, l/min/m22 ± 12 ± 02 ± 02 ± 03 ± 1
 RAP, mm Hg9 ± 710 ± 79 ± 79 ± 810 ± 8
 Systolic PAP, mm Hg45 ± 1644 ± 1542 ± 1241 ± 1443 ± 11
 Diastolic PAP, mm Hg24 ± 1023 ± 1023 ± 921 ± 1021 ± 7
 Mean PAP, mm Hg31 ± 1230 ± 1129 ± 1027 ± 1129 ± 9
 PCWP, mm Hg18 ± 717 ± 715 ± 713 ± 813 ± 7
 PA saturation, %59 ± 760 ± 661 ± 564 ± 467 ± 4
 BP, Doppler, mm Hg89 ± 788 ± 889 ± 889 ± 1188 ± 7
 LV EDD, cm6.3 ± 0.66.1 ± 0.76.0 ± 0.85.7 ± 0.95.5 ± 1.1
 % Reduction in LV EDD0 ± 0−2 ± 3−5 ± 6−8 ± 3−13 ± 13
 % With AV opening9182421810
 LV EDV, ml301 ± 77276 ± 76280 ± 76271 ± 72248 ± 93
 LV conicity0.73 ± 0.030.73 ± 0.030.74 ± 0.020.73 ± 0.020.74 ± 0.04
 LV sphericity0.72 ± 0.050.73 ± 0.050.72 ± 0.050.73 ± 0.040.71 ± 0.07
 RV EDV, ml238 ± 123230 ± 90254 ± 92258 ± 127279 ± 107
 RV septal curvature0.94 ± 0.110.81 ± 0.360.91 ± 0.130.86 ± 0.180.98 ± 0.09
 RV free-wall curvature1.21 ± 0.081.24 ± 0.081.24 ± 0.061.24 ± 0.071.24 ± 0.05

Values are mean ± SD.

AV = aortic valve; BP = blood pressure; CI = cardiac index; EDD = end-diastolic diameter; EDV = end-diastolic volume; HMII = HeartMate II; LV = left ventricular; PA = pulmonary artery; PAP = pulmonary artery pressure; PCWP = pulmonary capillary wedge pressure; PI = pulsatility index; RAP = right atrial pressure; RV = right ventricular.

  • % Reduction in LV EDD is determined by calculating the ratio in % between measured LV EDD at a given stage and LV EDD at the lowest pump speed. For example, for Stage II: % reduction in LV EDD = (LV EDD(Stage II) − LV EDD(Stage 1))/LV EDD(Stage I) × 100%.

  • Refers to the % of patients with aortic valve opening (intermittent or every beat) at that stage.