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Beat-to-beat noninvasive stroke volume from arterial pressure and Doppler ultrasound

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Abstract

The proper understanding of the cardiovascular mechanisms involved in complaints of short-lasting dizziness and the evaluation of unexplained recurrent syncope requires continuous monitoring of cardiac stroke volume (SV) in addition to blood pressure and heart rate. The primary aim of the present study was to evaluate a pulse wave analysis method that calculates beat-to-beat flow from non-invasive arterial pressure by simulating a non-linear, time-varying model of human aortic input impedance (Modelflow; MF), by comparing MF stroke volume (SVMF) to Doppler ultrasound (US) flow velocity SV (SVUS). A second purpose was to compare the two methods under two different conditions: the supine and head-up tilt (30°) position. SVUS and SVMF with non-invasive arterial pressure (Finapres) as input to the aortic model were measured beat-to-beat during spontaneous supine breathing and in the passive 30° head-up tilt (HUT30) position in six normotensive healthy humans [three females, mean age 24 (21–26) years]. There were variations in supine SV track between the two methods with zero difference and a SD of the beat-to-beat difference (MF−US) of 4.2%. HUT30 induced a systematic difference of 10.5% and an increase in SD to 6.9%, which was reproducible. Beat-to-beat changes in SV in the supine resting condition were equally well assessed by both methods. Systematic differences appear during HUT30 and show opposite signs. The difference between the two methods upon a change in body position may be attributed to limitations in each method.

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Acknowledgement

Supported by the Netherlands Heart Foundation (Grant 99.182).

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Authors and Affiliations

  1. Room F7-205, Academic Medical Center, Department of Internal Medicine and Cardiovascular Research Institute Amsterdam, University of Amsterdam, PO Box 22700, 1100 DE, Amsterdam, The Netherlands

    Johannes J. van Lieshout

  2. Institute of Basic Medical Sciences, Department of Physiology, University of Oslo, Boks 1103, Blindern Oslo, Norway

    Karin Toska, Morten Eriksen & Lars Walløe

  3. Norwegian Royal Air Force, Oslo, Norway

    Karin Toska

  4. Department of Intensive Care, Academic Medical Center and Cardiovascular Research Institute Amsterdam, Meibergdreef 9, 1105 AZ , Amsterdam, The Netherlands

    Erik Jan van Lieshout

  5. TNO Biomedical Instrumentation, Netherlands Organization for Applied Scientific Research, PO Box 22700, Amsterdam, The Netherlands

    Karel H. Wesseling

Authors
  1. Johannes J. van Lieshout
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  2. Karin Toska
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  3. Erik Jan van Lieshout
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  4. Morten Eriksen
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  5. Lars Walløe
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  6. Karel H. Wesseling
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Correspondence to Johannes J. van Lieshout.

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van Lieshout, J.J., Toska, K., van Lieshout, E.J. et al. Beat-to-beat noninvasive stroke volume from arterial pressure and Doppler ultrasound. Eur J Appl Physiol 90, 131–137 (2003). https://doi.org/10.1007/s00421-003-0901-8

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  • DOI: https://doi.org/10.1007/s00421-003-0901-8

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