Abnousi Freddy, Kang Guson, Giacomini John, Yeung Alan, Zarafshar Shirin, Vesom Nicholas, Ashley Euan, Harrington Robert, Yong Celina
1Division of Cardiovascular Medicine, Department of Medicine, Stanford University Medical Center, Palo Alto, CA USA.
2Yale School of Medicine, Palo Alto, CA USA.
NPJ Digit Med. 2019 Aug 21;2:80. doi: 10.1038/s41746-019-0159-0. eCollection 2019.
Current remote monitoring devices for heart failure have been shown to reduce hospitalizations but are invasive and costly; accurate non-invasive options remain limited. The EuleriAn Video Magnification ApPLications In Heart Failure StudY (AMPLIFY) pilot aimed to evaluate the accuracy of a novel noninvasive method that uses Eulerian video magnification. Video recordings were performed on the neck veins of 50 patients who were scheduled for right heart catheterization at the Palo Alto VA Medical Center. The recorded jugular venous pulsations were then enhanced by applying Eulerian phase-based motion magnification. Assessment of jugular venous pressure was compared across three categories: (1) physicians who performed bedside exams, (2) physicians who reviewed both the amplified and unamplified videos, and (3) direct invasive measurement of right atrial pressure from right heart catheterization. Motion magnification reduced inaccuracy of the clinician assessment of central venous pressure compared to the gold standard of right heart catheterization (mean discrepancy of -0.80 cm HO; 95% CI -2.189 to 0.612, = 0.27) when compared to both unamplified video (-1.84 cm HO; 95% CI -3.22 to -0.46, = 0.0096) and the bedside exam (-2.90 cm HO; 95% CI -4.33 to 1.40, = 0.0002). Major categorical disagreements with right heart catheterization were significantly reduced with motion magnification (12%) when compared to unamplified video (25%) or the bedside exam (27%). This novel method of assessing jugular venous pressure improves the accuracy of the clinical exam and may enable accurate remote monitoring of heart failure patients with minimal patient risk.
目前用于心力衰竭的远程监测设备已被证明可减少住院次数，但具有侵入性且成本高昂；准确的非侵入性选择仍然有限。欧拉视频放大技术在心力衰竭研究中的应用（AMPLIFY）试点旨在评估一种使用欧拉视频放大技术的新型非侵入性方法的准确性。在帕洛阿尔托退伍军人医疗中心，对50名计划进行右心导管插入术的患者的颈部静脉进行了视频记录。然后通过应用基于欧拉相位的运动放大技术增强记录的颈静脉搏动。对颈静脉压的评估分为三类进行比较：（1）进行床边检查的医生，（2）查看放大和未放大视频的医生，（3）通过右心导管插入术直接侵入性测量右心房压力。与右心导管插入术的金标准相比，运动放大技术降低了临床医生对中心静脉压评估的不准确性（平均差异为-0.80 cm HO；95%置信区间为-2.189至0.612，P = 0.27），与未放大视频（-1.84 cm HO；95%置信区间为-3.22至-0.46，P = 0.0096）和床边检查（-2.90 cm HO；95%置信区间为-4.33至1.40，P = 0.0002）相比。与右心导管插入术的主要分类不一致在运动放大技术下（12%）比未放大视频（25%）或床边检查（27%）显著减少。这种评估颈静脉压的新方法提高了临床检查的准确性，并可能以最小的患者风险实现对心力衰竭患者的准确远程监测。
