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应用运动心电图技术准确检测多巴酚丁胺引起的血液动力学变化:一项随机、双盲、安慰剂对照的验证研究。

Accurate Detection of Dobutamine-induced Haemodynamic Changes by Kino-Cardiography: A Randomised Double-Blind Placebo-Controlled Validation Study.

机构信息

LPHYS, Université Libre de Bruxelles, Bruxelles, Belgium.

BEAMS, Université Libre de Bruxelles, Bruxelles, Belgium.

出版信息

Sci Rep. 2019 Jul 19;9(1):10479. doi: 10.1038/s41598-019-46823-3.

DOI:10.1038/s41598-019-46823-3
PMID:31324831
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6642180/
Abstract

Non-invasive remote detection of cardiac and blood displacements is an important topic in cardiac telemedicine. Here we propose kino-cardiography (KCG), a non-invasive technique based on measurement of body vibrations produced by myocardial contraction and blood flow through the cardiac chambers and major vessels. KCG is based on ballistocardiography and measures 12 degrees-of-freedom (DOF) of body motion. We tested the hypothesis that KCG reliably assesses dobutamine-induced haemodynamic changes in healthy subjects. Using a randomized double-blinded placebo-controlled crossover study design, dobutamine and placebo were infused to 34 volunteers (25 ± 2 years, BMI 22 ± 2 kg/m², 18 females). Baseline recordings were followed by 3 sessions of increasing doses of dobutamine (5, 10, 20 μg/kg.min) or saline solution. During each session, stroke volume (SV) and cardiac output (CO) were determined by echocardiography and followed by a 90 s KCG recording. Measured linear accelerations and angular velocities were used to compute total Kinetic energy (iK) and power (Pmax). KCG sorted dobutamine infusion vs. placebo with 96.9% accuracy. Increases in SV and CO were correlated to iK (r = +0.71 and r = +0.8, respectively, p < 0.0001). Kino-cardiography, with 12-DOF, allows detecting dobutamine-induced haemodynamic changes with a high accuracy and present a major improvement over single axis ballistocardiography or seismocardiography.

摘要

无创远程检测心脏和血液位移是心脏远程医疗的一个重要课题。在这里,我们提出了运动心动描记术(KCG),这是一种基于心肌收缩和血液流经心脏腔室和主要血管产生的体振动测量的无创技术。KCG 基于振动心动描记术,测量 12 个自由度(DOF)的身体运动。我们测试了 KCG 是否能可靠地评估健康受试者多巴酚丁胺诱导的血液动力学变化的假设。使用随机双盲安慰剂对照交叉研究设计,将多巴酚丁胺和安慰剂输注给 34 名志愿者(25±2 岁,BMI 22±2kg/m²,18 名女性)。在基线记录后,进行了 3 次递增剂量的多巴酚丁胺(5、10、20μg/kg.min)或生理盐水输注。在每次输注期间,通过超声心动图确定每搏量(SV)和心输出量(CO),随后进行 90 秒的 KCG 记录。测量的线性加速度和角速度用于计算总动能(iK)和功率(Pmax)。KCG 将多巴酚丁胺输注与安慰剂以 96.9%的准确率进行分类。SV 和 CO 的增加与 iK 相关(r=+0.71 和 r=+0.8,分别为 p<0.0001)。具有 12 自由度的运动心动描记术可以以高准确度检测多巴酚丁胺诱导的血液动力学变化,比单轴振动心动描记术或地震心动描记术有了重大改进。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47e6/6642180/e346b8c32d08/41598_2019_46823_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47e6/6642180/a7d1f6b6238f/41598_2019_46823_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47e6/6642180/e346b8c32d08/41598_2019_46823_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47e6/6642180/a7d1f6b6238f/41598_2019_46823_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47e6/6642180/27846e0bf2cf/41598_2019_46823_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47e6/6642180/a27b20d529ed/41598_2019_46823_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47e6/6642180/6710ce288c59/41598_2019_46823_Fig4_HTML.jpg
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