Bernstein Donald P, Henry Isaac C, Lemmens Harry J, Chaltas Janell L, DeMaria Anthony N, Moon James B, Kahn Andrew M
Sotera Wireless, Inc., 10020 Huennekens Street, San Diego, CA, 92121, USA.
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, 94305-5115, USA.
J Clin Monit Comput. 2015 Dec;29(6):789-800. doi: 10.1007/s10877-015-9668-9. Epub 2015 Feb 15.
The goal of this study is to validate a new, continuous, noninvasive stroke volume (SV) method, known as transbrachial electrical bioimpedance velocimetry (TBEV). TBEV SV was compared to SV obtained by cardiac magnetic resonance imaging (cMRI) in normal humans devoid of clinically apparent heart disease. Thirty-two (32) volunteers were enrolled in the study. Each subject was evaluated by echocardiography to assure that no aortic or mitral valve disease was present. Subsequently, each subject underwent electrical interrogation of the brachial artery by means of a high frequency, low amplitude alternating current. A first TBEV SV estimate was obtained. Immediately after the initial TBEV study, subjects underwent cMRI, using steady-state precession imaging to obtain a volumetric estimate of SV. Following cMRI, the TBEV SV study was repeated. Comparing the cMRI-derived SV to that of TBEV, the two TBEV estimates were averaged and compared to the cMRI standard. CO was computed as the product of SV and heart rate. Statistical methods consisted of Bland-Altman and linear regression analysis. TBEV SV and CO estimates were obtained in 30 of the 32 subjects enrolled. Bland-Altman analysis of pre- and post-cMRI TBEV SV showed a mean bias of 2.87 % (2.05 mL), precision of 13.59% (11.99 mL) and 95% limits of agreement (LOA) of +29.51% (25.55 mL) and -23.77% (-21.45 mL). Regression analysis for pre- and post-cMRI TBEV SV values yielded y = 0.76x + 25.1 and r(2) = 0.71 (r = 0.84). Bland-Altman analysis comparing cMRI SV with averaged TBEV SV showed a mean bias of -1.56% (-1.53 mL), precision of 13.47% (12.84 mL), 95% LOA of +24.85% (+23.64 mL) and -27.97% (-26.7 mL) and percent error = 26.2 %. For correlation analysis, the regression equation was y = 0.82x + 19.1 and correlation coefficient r(2) = 0.61 (r = 0.78). Bland-Altman analysis of averaged pre- and post-cMRI TBEV CO versus cMRI CO yielded a mean bias of 5.01% (0.32 L min(-1)), precision of 12.85% (0.77 L min(-1)), 95% LOA of +30.20 % (+0.1.83 L min(-1)) and -20.7% (-1.19 L min(-1)) and percent error = 24.8%. Regression analysis yielded y = 0.92x + 0.78, correlation coefficient r(2) = 0.74 (r = 0.86). TBEV is a novel, noninvasive method, which provides satisfactory estimates of SV and CO in normal humans.
本研究的目的是验证一种新的、连续的、无创的每搏输出量（SV）测量方法，即经肱动脉电阻抗血流速度测量法（TBEV）。在无明显临床心脏病的正常人群中，将TBEV测量的SV与通过心脏磁共振成像（cMRI）获得的SV进行比较。32名志愿者参与了本研究。通过超声心动图对每名受试者进行评估，以确保不存在主动脉或二尖瓣疾病。随后，通过高频、低振幅交流电对每名受试者的肱动脉进行电检测，获得首次TBEV SV估计值。在首次TBEV研究后，受试者立即接受cMRI检查，采用稳态进动成像获取SV的容积估计值。cMRI检查后，重复进行TBEV SV研究。将cMRI得出的SV与TBEV得出的SV进行比较，对两次TBEV估计值求平均值并与cMRI标准值进行比较。心输出量（CO）计算为SV与心率的乘积。统计方法包括Bland-Altman分析和线性回归分析。在32名入组受试者中的30名获得了TBEV SV和CO估计值。对cMRI前后的TBEV SV进行Bland-Altman分析，结果显示平均偏差为2.87%（2.05 mL），精密度为13.59%（11.99 mL），95%一致性界限（LOA）为+29.51%（25.55 mL）和-23.77%（-21.45 mL）。对cMRI前后的TBEV SV值进行回归分析，得出y = 0.76x + 25.1，r(2) = 0.71（r = 0.84）。将cMRI SV与TBEV平均SV进行Bland-Altman分析，结果显示平均偏差为-1.56%（-1.53 mL），精密度为13.47%（12.84 mL），95% LOA为+24.85%（+23.64 mL）和-27.97%（-26.7 mL），误差百分比为26.2%。对于相关性分析，回归方程为y = 0.82x + 19.1，相关系数r(2) = 0.61（r = 0.78）。对cMRI前后的TBEV平均CO与cMRI CO进行Bland-Altman分析，结果显示平均偏差为5.01%（0.32 L min(-1)），精密度为12.85%（0.77 L min(-1)），95% LOA为+30.20 %（+0.1.83 L min(-1)）和-20.7%（-1.19 L min(-1)），误差百分比为24.8%。回归分析得出y = 0.92x + 0.78，相关系数r(2) = 0.74（r = 0.86）。TBEV是一种新型无创方法，可在正常人群中提供令人满意的SV和CO估计值。
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