Document Detail


Estimating changes in cardiac output using an implanted hemodynamic monitor in heart failure patients.
MedLine Citation:
PMID:  20450462     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to evaluate an algorithm that estimates changes in cardiac output (CO) from right ventricular (RV) pressure waveforms derived from an implantable hemodynamic monitor (IHM) in heart failure patients. DESIGN: Twelve heart failure patients (NYHA II-III, EF 32%) with an implantable hemodynamic monitor (Chronicle) were included in this study. Changes in cardiac output were provoked by body position change at rest (left lateral supine, horizontal supine, sitting, and standing) and a steady state bicycle exercise at 20 watts. Estimated CO derived from the IHM (CO(IHM)) was compared to CO measured with inert gas rebreathing (CO(RB)), echocardiography (CO(ECHO)) and impedance cardiography (CO(ICG)). CO(RB) was considered the reference method. RESULTS: The median intra-patient correlation coefficient comparing CO(RB) and CO(IHM) was 0.83 (range: 0.63-0.98). Comparing CO(RB) with CO(ECHO) and CO(ICG) resulted in mean intra-patient correlation coefficients of 0.73 (-0.29-0.94) and 0.63 (-0.29-0.96). In a statistical model where slope and intercept was considered random between patients the coefficient of determination (R2) comparing CO(RB) and CO(IHM) was 0.91. Mean bias was -0.39 L/min (11%). Limits of agreement were +/-1.56 L/min and relative error was 21%. CONCLUSIONS: A simple algorithm based on RV pressure wave form characteristics derived from an IHM can be used to estimate changes in CO in heart failure patients. These findings encourage further research aiming to improve and validate the algorithm.
Authors:
Marcus Ståhlberg; Morten Damgaard; David Ersgård; Peter Norsk; Mustafa Karamanoglu; Cecilia Linde; Frieder Braunschweig
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  44     ISSN:  1651-2006     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  201-8     Citation Subset:  IM    
Affiliation:
Karolinska Institutet, Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. marcus.stahlberg@ki.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Algorithms
Cardiac Output*
Cardiography, Impedance
Echocardiography
Electrodes, Implanted
Equipment Design
Exercise
Heart Failure / diagnosis*,  physiopathology
Humans
Male
Middle Aged
Models, Statistical
Monitoring, Ambulatory / instrumentation*
Posture
Predictive Value of Tests
Reproducibility of Results
Signal Processing, Computer-Assisted
Time Factors
Transducers, Pressure
Ventricular Function, Right
Ventricular Pressure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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