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基于动脉压和多普勒超声的逐搏无创每搏输出量

Beat-to-beat noninvasive stroke volume from arterial pressure and Doppler ultrasound.

作者信息

van Lieshout Johannes J, Toska Karin, van Lieshout Erik Jan, Eriksen Morten, Walløe Lars, Wesseling Karel H

机构信息

Room F7-205, Academic Medical Center, Department of Internal Medicine and Cardiovascular Research Institute Amsterdam, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands.

出版信息

Eur J Appl Physiol. 2003 Sep;90(1-2):131-7. doi: 10.1007/s00421-003-0901-8. Epub 2003 Jul 8.

Abstract

The proper understanding of the cardiovascular mechanisms involved in complaints of short-lasting dizziness and the evaluation of unexplained recurrent syncope requires continuous monitoring of cardiac stroke volume (SV) in addition to blood pressure and heart rate. The primary aim of the present study was to evaluate a pulse wave analysis method that calculates beat-to-beat flow from non-invasive arterial pressure by simulating a non-linear, time-varying model of human aortic input impedance (Modelflow; MF), by comparing MF stroke volume (SV(MF)) to Doppler ultrasound (US) flow velocity SV (SV(US)). A second purpose was to compare the two methods under two different conditions: the supine and head-up tilt (30 degrees ) position. SV(US) and SV(MF) with non-invasive arterial pressure (Finapres) as input to the aortic model were measured beat-to-beat during spontaneous supine breathing and in the passive 30 degrees head-up tilt (HUT30) position in six normotensive healthy humans [three females, mean age 24 (21-26) years]. There were variations in supine SV track between the two methods with zero difference and a SD of the beat-to-beat difference (MF-US) of 4.2%. HUT30 induced a systematic difference of 10.5% and an increase in SD to 6.9%, which was reproducible. Beat-to-beat changes in SV in the supine resting condition were equally well assessed by both methods. Systematic differences appear during HUT30 and show opposite signs. The difference between the two methods upon a change in body position may be attributed to limitations in each method.

摘要

要正确理解短暂性头晕症状所涉及的心血管机制以及评估不明原因的反复晕厥,除了血压和心率外,还需要持续监测心搏量(SV)。本研究的主要目的是评估一种脉搏波分析方法,该方法通过模拟人主动脉输入阻抗的非线性、时变模型(模型流;MF),从无创动脉压计算逐搏流量,即将MF心搏量(SV(MF))与多普勒超声(US)流速SV(SV(US))进行比较。第二个目的是在两种不同条件下比较这两种方法:仰卧位和头高位倾斜(30度)位。在6名血压正常的健康人[3名女性,平均年龄24(21 - 26)岁]的自主仰卧呼吸期间以及被动头高位倾斜30度(HUT30)位时,以无创动脉压(Finapres)作为主动脉模型的输入,逐搏测量SV(US)和SV(MF)。两种方法在仰卧位SV轨迹上存在差异,差异为零,逐搏差异(MF - US)的标准差为4.2%。HUT30引起了10.5%的系统差异,标准差增加到6.9%,且具有可重复性。两种方法对仰卧位静息状态下SV的逐搏变化评估效果相当。在HUT30期间出现系统差异且呈现相反的迹象。体位改变时两种方法之间的差异可能归因于每种方法的局限性。

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