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Myocardial Hemodynamics During Exercise Treadmill Test By a Computer-Aided Clinical Decision System

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Cardiovascular Engineering

Abstract

Objective: By applying a clinical decision system, the Noninvasive Hemodynamic Analyzer (NHA), demonstrates its capability to compute the Myocardial Hemodynamic status of exercising patients. Design: Retrospective study to use the average vital signs and anthropological data of a large clinical trial of Exercise Treadmill Test. The NHA system computes Stroke Volume and various hemodynamic parameters. With the assistance of the NHA computer-aided clinical decision system; the Epicardial and Endocardial Blood Pressure/Blood Flow relationships, as well as components or determinants of Myocardial Oxygen Supply during exercise treadmill test were calculated. Patients: Four groups of the clinical study (1) Healthy, (2) Hypertensive, (3) Angina Pectoris, and (4) Post-Myocardial Infarction and Angina Pectoris were used in this study which comprised the average data of several hundred patients. Each group had three subgroups according to the Exercise Treadmill Test, upright and two exercise periods. Validity: We previously conducted a comparative study of Stroke Volume computed by the NHA with the Thermodilution technique which proved to be clinically acceptable concerning Bias, Accuracy, and Precision. In this particular study, the statistical evaluation was not available because the average values did not allow for such computation. Instead, we have chosen to compute the Myocardial Hemodynamic Parameters parallel with their Ideal values. Altogether 18 hemodynamic parameters were included and the normal values were expressed in ± 20%. Conclusion: The NHA clinical decision system can differentiate among the reported clinical conditions of the “Seattle Heart Watch” report. We were able to comparatively evaluate physiological and pathophysiological principles, such as, coronary flow reserve, endocardial autoregulation, and remodeling. Further medical trials will reveal the practical clinical importance and applicability of our NHA system.

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Authors and Affiliations

  1. Reston Noninvasive Hemodynamic Center, Reston, Virginia

    John Kabal & Bruce K. Lagerman

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  1. John Kabal
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  2. Bruce K. Lagerman
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Correspondence to Bruce K. Lagerman.

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Kabal, J., Lagerman, B.K. Myocardial Hemodynamics During Exercise Treadmill Test By a Computer-Aided Clinical Decision System. Cardiovasc Eng 5, 171–185 (2005). https://doi.org/10.1007/s10558-005-9071-0

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