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Estimation of beat-to-beat changes in stroke volume from arterial pressure: A comparison of two pressure wave analysis techniques during head-up tilt testing in young, healthy men

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Abstract

Objective

The aim of this study was to compare beat-to-beat changes in stroke volume (SV) estimated by two different pressure wave analysis techniques during orthostatic stress testing: pulse contour analysis and Modelflow,ie, simulation of a three-element model of aortic input impedance.

Methods

A reduction in SV was introduced in eight healthy young men (mean age, 25; range, 19–32 y) by a 30-minute head-up tilt maneuver. Intrabrachial and noninvasive finger pressure were monitored simultaneously. Beat-to-beat changes in SV were estimated from intrabrachial pressure by pulse contour analysis and Modelflow. In addition, the relative differences in Modelflow SV obtained from intrabrachial pressure and noninvasive finger pressure were assessed.

Results

Beat-to-beat changes in Modelflow SV from intrabrachial pressure were comparable with pluse contour measures. The relative difference between the two methods amounted to 0.1±1% (mean±SEM) and was not dependent on the duration of tilt. The diference between Modelflow apoplied to intrabrachial pressure and finger pressure amounted to −2.7±1.3% (p=0.04). This difference was not dependent on the duration of tilt or level of arterial pressure.

Conclusions

Based on different mathematical models of the human arterial system, pulse contour and Modelflow compute similar changes in SV from intrabrachial pressure during orthostatic stress testing in young healthy men. The magnitude of the differnece in SV derived from intrabrachial and finger pressure may vary among subjects; Modelflow SV from noninvasive finger pressure tracks fast and brisk changes in SV derived from intrabrachial pressure.

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Authors and Affiliations

  1. Department of TNO-BioMedical Instrumentation, Academic Medical Center, Amsterdam, The Netherlands

    Karel H. Wesseling M. Sc.

  2. Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands

    Hans Oosting M.Sc.

  3. Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Room F4-257, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands

    Wilbert T. Jellema M.D., Ben P. M. Imholz Ph.D. & Johannes J. van Lieshout Ph.D.

Authors
  1. Wilbert T. Jellema M.D.
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  2. Ben P. M. Imholz Ph.D.
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  3. Hans Oosting M.Sc.
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  4. Karel H. Wesseling M. Sc.
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  5. Johannes J. van Lieshout Ph.D.
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Correspondence to Wilbert T. Jellema M.D..

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Jellema, W.T., Imholz, B.P.M., Oosting, H. et al. Estimation of beat-to-beat changes in stroke volume from arterial pressure: A comparison of two pressure wave analysis techniques during head-up tilt testing in young, healthy men. Clinical Autonomic Research 9, 185–192 (1999). https://doi.org/10.1007/BF02330482

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  • DOI: https://doi.org/10.1007/BF02330482

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