Department of Movement and Training Science, Leipzig University, Leipzig, Germany.
Department of Exercise Science, Philipps University of Marburg, Marburg, Germany.
PLoS One. 2024 May 13;19(5):e0302793. doi: 10.1371/journal.pone.0302793. eCollection 2024.
In cardiology, cardiac output (CO) is an important parameter for assessing cardiac function. While invasive thermodilution procedures are the gold standard for CO assessment, transthoracic Doppler echocardiography (TTE) has become the established method for routine CO assessment in daily clinical practice. However, a demand persists for non-invasive approaches, including oscillometric pulse wave analysis (PWA), to enhance the accuracy of CO estimation, reduce complications associated with invasive procedures, and facilitate its application in non-intensive care settings. Here, we aimed to compare the TTE and oscillometric PWA algorithm Antares for a non-invasive estimation of CO.
Non-invasive CO data obtained by two-dimensional TTE were compared with those from an oscillometric blood pressure device (custo med GmbH, Ottobrunn, Germany) using the integrated algorithm Antares (Redwave Medical GmbH, Jena, Germany). In total, 59 patients undergoing elective cardiac catheterization for clinical reasons (71±10 years old, 76% males) were included. Agreement between both CO measures were assessed by Bland-Altman analysis, Student's t-test, and Pearson correlations.
The mean difference in CO was 0.04 ± 1.03 l/min (95% confidence interval for the mean difference: -0.23 to 0.30 l/min) for the overall group, with lower and upper limits of agreement at -1.98 and 2.05 l/min, respectively. There was no statistically significant difference in means between both CO measures (P = 0.785). Statistically significant correlations between TTE and Antares CO were observed in the entire cohort (r = 0.705, P<0.001) as well as in female (r = 0.802, P<0.001) and male patients (r = 0.669, P<0.001).
The oscillometric PWA algorithm Antares and established TTE for a non-invasive estimation of CO are highly correlated in male and female patients, with no statistically significant difference between both approaches. Future validation studies of the Antares CO are necessary before a clinical application can be considered.
在心脏病学中，心输出量（CO）是评估心功能的一个重要参数。虽然有创热稀释法是 CO 评估的金标准，但经胸多普勒超声心动图（TTE）已成为日常临床实践中常规 CO 评估的既定方法。然而，人们仍然需要非侵入性的方法，包括振荡血压分析（PWA），以提高 CO 估计的准确性，减少与有创程序相关的并发症，并促进其在非重症监护环境中的应用。在这里，我们旨在比较 TTE 和振荡血压分析算法 Antares 用于非侵入性 CO 估计。
使用二维 TTE 获得的非侵入性 CO 数据与使用集成算法 Antares（德国 Jena 的 Redwave Medical GmbH）的振荡血压设备（德国 Ottobrunn 的 custo med GmbH）获得的 CO 数据进行比较。共有 59 名因临床原因接受择期心导管检查的患者（71±10 岁，76%为男性）被纳入研究。通过 Bland-Altman 分析、学生 t 检验和 Pearson 相关性评估两种 CO 测量方法之间的一致性。
在整个组中，CO 的平均差异为 0.04±1.03 l/min（平均差的 95%置信区间为-0.23 至 0.30 l/min），其上下限分别为-1.98 和 2.05 l/min。两种 CO 测量方法之间的平均值没有统计学差异（P = 0.785）。在整个队列中观察到 TTE 和 Antares CO 之间存在统计学上显著的相关性（r = 0.705，P<0.001），在女性（r = 0.802，P<0.001）和男性患者（r = 0.669，P<0.001）中也是如此。
在男性和女性患者中，振荡血压分析算法 Antares 和已建立的 TTE 用于非侵入性 CO 估计高度相关，两种方法之间没有统计学差异。在考虑临床应用之前，需要对 Antares CO 的进一步验证研究。
