期刊
PHYSIOLOGICAL MEASUREMENT
卷 39, 期 9, 页码 -出版社
IOP Publishing Ltd
DOI: 10.1088/1361-6579/aada72
关键词
pulse transit time; pulse wave velocity; pre-ejection period; electrocardiogram; compliance
资金
- Medtech CoRE
- Royal Society of New Zealand Cook Fellowship
- Ministry of Business and Innovation (National Science Chellenge)
Objective Pulse wave velocity measurements are an indicator of arterial stiffness and possible cardiovascular dysfunction. It is usually calculated by measuring the pulse transit time (PTT) over a known distance through the arteries. In animal studies, reliable PTT measures can be obtained using two pressure catheters. However, such direct, invasive methods are undesirable in dinical settings. A less invasive alternative measure of PTT is pulse arrival time (PAT), the time between the Q-wave of an electrocardiogram (ECG) and the arrival of the foot of the beats pressure waveform at one pressure catheter. Since the Q- wave signifies the start of ventricular contraction, PAT includes the pre-ejection period (PEP), a time where no blood is ejected. Thus, inter- or intra- subject variation in PEP could result in poor correlation between pulse arrival time (PAT) and the desired pulse transit time (PTT). Approach: This study looks at the relationship between PAT and PTT, over a range of common critical care therapies and determines the effect of PEP on PAT as a possible surrogate of PTT in a critical care environment. The analysis uses data from five porcine experiments, where ECG, aortic arch and abdominal aortic pressure were measured simultaneously, over a range of induced hemodynamic conditions. Results: The resulting correlations of PAT verse PTT varied within pigs and across interventions (r(2) = 0.32-0.69), and across pigs (r(2) = 0.05-0.60). Variability was due to three main causes. First, the interventions themselves effect PEP and PTT differently, second, pig specific response to the interventions, and third, inter- and intra- pig variability in PEP, independent of PIT. Significance: The overall analysis shows PAT is an unreliable measure of PTT and a poor surrogate under dinical interventions common in a critical care setting, due to intra- and inter- subject variability in PEP.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据