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Annals of Biomedical Engineering

, Volume 46, Issue 1, pp 171–185 | Cite as

Beat-by-Beat Estimation of the Left Ventricular Pressure–Volume Loop Under Clinical Conditions

  • Shaun DavidsonEmail author
  • Chris Pretty
  • Shun Kamoi
  • Thomas Desaive
  • J. Geoffrey Chase
Article

Abstract

This paper develops a method for the minimally invasive, beat-by-beat estimation of the left ventricular pressure–volume loop. This method estimates the left ventricular pressure and volume waveforms that make up the pressure–volume loop using clinically available inputs supported by a short, baseline echocardiography reading. Validation was performed across 142,169 heartbeats of data from 11 Piétrain pigs subject to two distinct protocols encompassing sepsis, dobutamine administration and clinical interventions. The method effectively located pressure–volume loops, with low overall median errors in end-diastolic volume of 8.6%, end-systolic volume of 17.3%, systolic pressure of 19.4% and diastolic pressure of 6.5%. The method further demonstrated a low overall mean error of 23.2% predicting resulting stroke work, and high correlation coefficients along with a high percentage of trend compass ‘in band’ performance tracking changes in stroke work as patient condition varied. This set of results forms a body of evidence for the potential clinical utility of the method. While further validation in humans is required, the method has the potential to aid in clinical decision making across a range of clinical interventions and disease state disturbances by providing real-time, beat-to-beat, patient specific information at the intensive care unit bedside without requiring additional invasive instrumentation.

Keywords

Elastance Cardiovascular monitoring End-systolic pressure–volume relation Sepsis Dobutamine Stroke work 

Notes

Acknowledgments

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Copyright information

© Biomedical Engineering Society 2017

Authors and Affiliations

  1. 1.Department of Mechanical EngineeringUniversity of CanterburyChristchurchNew Zealand
  2. 2.GIGA-Cardiovascular SciencesUniversity of LiègeLiègeBelgium

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