Panagiotou Marios, Vogiatzis Ioannis, Jayasekera Geeshath, Louvaris Zafeiris, Mackenzie Alison, Mcglinchey Neil, Baker Julien S, Church Alistair C, Peacock Andrew J, Johnson Martin K
Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital, Glasgow, UK.
Faculty of Physical Education and Sports Sciences, National and Kapodistrian University of Athens, Athens, Greece.
Clin Physiol Funct Imaging. 2018 Mar;38(2):254-260. doi: 10.1111/cpf.12408. Epub 2017 Feb 6.
Non-invasive methods of measuring cardiac output are highly desirable in pulmonary arterial hypertension (PAH). We therefore sought to validate impedance cardiography (ICG) against thermodilution (TD) and cardiac magnetic resonance (CMR) in the measurement of cardiac output in patients under investigation for PAH.
A prospective, cross-sectional study was performed to compare single-point measurements of cardiac output obtained by impedance cardiography (CO ) technology (PhysioFlow ) with (i) contemporaneous TD measurements (CO ) at rest and steady-state exercise during right heart catheterization and (ii) CMR measurements (CO ) at rest obtained within 72 h.
Paired CO and CO measurements were obtained in 25 subjects at rest and 16 subjects at exercise. CO measurements were obtained in 16 subjects at rest. There was unsatisfactory correlation and agreement between CO and CO at rest (r = 0·42, P = 0·035; bias: 1·21 l min , 95% CI: -2·33 to 4·75 l min ) and exercise (r = .65, P = .007; bias: 1·41 l min ; 95% CI: -3·99 to 6·81 l min ) and in the change in CO and CO from rest to exercise (r = 0·53, P = 0·033; bias: 0·76 l min , 95% CI: -3·74 to 5·26 l min ). There was also a lack of correlation and unsatisfactory agreement between resting CO and CO (r = 0·38, P = 0·1; bias: 1·40 l min , 95% CI: -2·48 to 5·28 l min ). In contrast, there was close correlation and agreement between resting CO and CO (r = 0·87, P<0·001; bias: -0·16 l min , 95% CI: -1·97 to 1·65).
In a representative population of patients under investigation for PAH, ICG showed insufficient qualitative and quantitative value in the measurement of resting and exercise cardiac output when compared with TD and CMR.
在肺动脉高压（PAH）患者中，非常需要非侵入性的心输出量测量方法。因此，我们试图在对PAH进行调查的患者中，验证阻抗心动图（ICG）与热稀释法（TD）和心脏磁共振成像（CMR）在心输出量测量方面的差异。
进行了一项前瞻性横断面研究，以比较通过阻抗心动图（CO）技术（PhysioFlow）获得的单点心输出量测量值与（i）右心导管检查期间静息和稳态运动时的同期TD测量值（CO），以及（ii）在72小时内获得的静息状态下的CMR测量值（CO）。
在25名静息受试者和16名运动受试者中获得了配对的CO和CO测量值。在16名静息受试者中获得了CO测量值。静息时CO和CO之间的相关性和一致性不理想（r = 0·42，P = 0·035；偏差：1·21 l/min，95%CI：-2·33至4·75 l/min），运动时（r = 0·65，P = 0·007；偏差：1·41 l/min；95%CI：-3·99至6·81 l/min）以及静息到运动时CO和CO的变化之间（r = 0·53，P = 0·033；偏差：0·76 l/min，95%CI：-3·74至5·26 l/min）。静息时的CO和CO之间也缺乏相关性且一致性不理想（r = 0·38，P = 0·1；偏差：1·40 l/min，95%CI：-2·48至5·28 l/min）。相比之下，静息时的CO和CO之间具有密切的相关性和一致性（r = 0·87，P<0·001；偏差：-0·16 l/min，95%CI：-1·97至1·65）。
在PAH调查的代表性患者群体中，与TD和CMR相比，ICG在静息和运动心输出量测量方面的定性和定量价值不足。
