Altamirano-Diaz Luis, Welisch Eva, Rauch Ralf, Miller Michael, Park Teresa Sohee, Norozi Kambiz
Division of Paediatric Cardiology, Department of Paediatrics, Western University, 800 Commissioners Rd E, PO Box 5010, London, N6A 5W9s, Canada.
Children's Health Research Institute, London, Canada.
J Clin Monit Comput. 2018 Feb;32(1):45-52. doi: 10.1007/s10877-017-9994-1. Epub 2017 Feb 17.
Electrical cardiometry (EC) is a non-invasive and inexpensive method for hemodynamic assessment and monitoring. However, its feasibility for widespread clinical use, especially for the obese population, has yet to be determined. In this study, we evaluated the agreement and reliability of EC compared to transthoracic Doppler echocardiography (TTE) in normal, overweight, and obese children and adolescents. We measured stroke volume (SV) and cardiac output (CO) of 131 participants using EC and TTE simultaneously. We further divided these participants according to BMI percentiles for subanalyses: <85% normal weight (n = 41), between 85 and 95% overweight (n = 7), and >95% obese (n = 83). Due to small sample size of the overweight group, we combined overweight and obese groups (OW+OB) with no significant change in results (SV and CO) before and after combining groups. There were strong correlations between EC and TTE measurements of SV (r = 0.869 and r = 0.846; p < 0.0001) and CO (r = 0.831 and r = 0.815; p < 0.0001) in normal and OW+OB groups, respectively. Bias and percentage error for CO measurements were 0.240 and 29.7%, and 0.042 and 29.5% in the normal and OW+OB groups, respectively. Indexed values for SV were lower in the OW+OB group than in the normal weight group when measured by EC (p < 0.0001) but no differences were seen when measured by TTE (p = 0.096). In all weight groups, there were strong correlations and good agreement between EC and TTE. However, EC may underestimate hemodynamic measurements in obese participants due to fat tissue.
心电描记术（EC）是一种用于血流动力学评估和监测的非侵入性且成本低廉的方法。然而，其在广泛临床应用中的可行性，尤其是在肥胖人群中的可行性，尚未得到确定。在本研究中，我们评估了在正常、超重和肥胖儿童及青少年中，EC与经胸多普勒超声心动图（TTE）相比的一致性和可靠性。我们同时使用EC和TTE测量了131名参与者的每搏输出量（SV）和心输出量（CO）。我们根据BMI百分位数进一步将这些参与者进行亚组分析：体重正常（<85%，n = 41）、超重（85%至95%，n = 7）和肥胖（>95%，n = 83）。由于超重组样本量较小，我们将超重和肥胖组合并为超重+肥胖组（OW+OB），合并前后结果（SV和CO）无显著变化。在正常组和OW+OB组中，EC与TTE测量的SV（r = 0.869和r = 0.846；p < 0.0001）和CO（r = 0.831和r = 0.815；p < 0.0001）之间分别存在强相关性。正常组和OW+OB组中CO测量的偏差和百分比误差分别为0.240和29.7%，以及0.042和29.5%。通过EC测量时，OW+OB组的SV指数值低于正常体重组（p < 0.0001），但通过TTE测量时未见差异（p = 0.096）。在所有体重组中，EC与TTE之间均存在强相关性和良好的一致性。然而，由于脂肪组织的存在，EC可能会低估肥胖参与者的血流动力学测量值。
