应用心电导联法与经胸超声多普勒心动图对比测量主动脉缩窄修补术后患儿的心输出量：一项非侵入性研究。

Non-invasive measurement of cardiac output in children with repaired coarctation of the aorta using electrical cardiometry compared to transthoracic Doppler echocardiography.

机构信息

Department of Paediatrics, Western University, London, Ontario, Canada. Children's Health Research Institute, London, Ontario, Canada. Paediatric Cardiopulmonary Research Laboratory, London Health Sciences Centre, London, Ontario, Canada.

出版信息

Physiol Meas. 2018 May 17;39(5):055003. doi: 10.1088/1361-6579/aac02b.

DOI:10.1088/1361-6579/aac02b

PMID:29695645

Abstract

OBJECTIVE

To evaluate the equivalence of the ICON electrical cardiometry (EC) haemodynamic monitor to measure cardiac output (CO) relative to transthoracic Doppler echocardiography (TTE) in paediatric patients with repaired coarctation of the aorta (CoA).

APPROACH

A group of n = 28 CoA patients and n = 27 matched controls were enrolled. EC and TTE were performed synchronously on each participant and CO measurements compared using linear regression and Bland-Altman analysis. The CoA group was further subdivided into two groups, with n = 10 and without n = 18 increased left ventricular outflow tract velocity (iLVOTv) for comparison.

MAIN RESULTS

CO measurements from EC and TTE in controls showed a strong correlation (R = 0.80, p < 0.001) and an acceptable percentage error (PE) of 28.1%. However, combining CoA and control groups revealed a moderate correlation (R = 0.57, p < 0.001) and a poor PE (44.2%). We suspected that the CO in a subset of CoA participants with iLVOTv was overestimated by TTE. Excluding the iLVOTv CoA participants improved the correlation (R = 0.77, p < 0.001) and resulted in an acceptable PE of 31.2%.

SIGNIFICANCE

CO measurements in paediatric CoA patients in the absence of iLVOTv are clinically equivalent between EC and TTE. The presence of iLVOTv may impact the accuracy of CO measurement by TTE, but not EC.

摘要

目的

评估 ICON 电子心排量（EC）血流动力学监测仪在经胸超声心动图（TTE）测量修复性主动脉缩窄（CoA）患儿心输出量（CO）时的等效性。

方法

共纳入 28 例 CoA 患者和 27 例匹配的对照组。对每位参与者同步进行 EC 和 TTE 检查，采用线性回归和 Bland-Altman 分析比较 CO 测量值。将 CoA 组进一步分为左心室流出道速度增加（iLVOTv）组（n=10）和无 iLVOTv 组（n=18）进行比较。

主要结果

对照组中 EC 和 TTE 的 CO 测量值相关性较强（R=0.80，p<0.001），百分比误差（PE）为 28.1%。然而，将 CoA 组和对照组合并后，相关性中等（R=0.57，p<0.001），PE 较差（44.2%）。我们怀疑 TTE 高估了部分 CoA 患者伴有 iLVOTv 的 CO。排除伴有 iLVOTv 的 CoA 患者后，相关性得到改善（R=0.77，p<0.001），PE 为 31.2%，可接受。