Assessment of cardiac output from noninvasive determination of arterial pressure profile in subjects at rest

Antonutto, G.; Girardis, Massimo; Tuniz, D; Petri, Else; Capelli, Carlo

doi:10.1007/bf01094786

Cited by 13 publications

(13 citation statements)

References 16 publications

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“…This technique was considered adequate to achieve our aim although we are aware of a shortcoming in that the technique does not register beatby-beat SV. A recently developed method, the Pulse Contour Method (Antonutto et al 1994(Antonutto et al , 1995 does achieve this, as well as measuring CO, noninvasively. Therefore, further studies are necessary to clarify the responses of SV and CO to the interaction between posture changes and limb movements during recovery from exercise using other reliable techniques, such as Doppler ultrasound and pulse contour methods.…”

Section: Limitationsmentioning

confidence: 98%

Effects of the muscle pump and body posture on cardiovascular responses during recovery from cycle exercise

et al. 2005

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The purpose of the study was to characterize the effects of muscular contractions (the muscle pump) and body posture on cardiovascular responses during recovery from moderate exercise in the upright-sitting or supine positions. Heart rate (HR), stroke volume (SV), and cardiac output (CO) were measured in seven young male subjects at rest and during 10-min of cycle exercise at 60% of peak oxygen uptake (VO2peak). This was followed by either complete rest for 5 min (inactive recovery) or cycling at VO2peak for 5 min (active recovery) in the upright or supine positions. In the upright position, an initial rapid decrease in HR was followed by a gradual decrease in HR, and this response was similar when comparing inactive and active recoveries. Upright SV during inactive recovery decreased gradually to the pre-exercise resting level, whereas upright SV during active recovery remained significantly elevated. In contrast, in the supine position, the HR during active recovery decreased, but remained significantly higher than that during inactive recovery. Changes in supine SV were similar when comparing inactive and active recovery. Thus, maintenance of SV and HR resulted in significantly greater CO during active recovery than during inactive recovery, regardless of body position. HR was greater during supine active-recovery than during supine inactive-recovery, and there was no difference in SV. These data suggest that the muscle pump is less important in facilitating venous return and vagal resumption in the supine position as compared to the upright position.

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Section: Limitationsmentioning

confidence: 98%

Effects of the muscle pump and body posture on cardiovascular responses during recovery from cycle exercise

et al. 2005

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“…However, advances in the area potentially provides more readily available and less invasive modalities that may encourage more widespread use of the goal-directed approach (Bundgaard-Nielsen et al 2007b; Kehlet and Bundgaard-Nielsen 2009). Ultrasound (Sugawara et al 2003; Van Lieshout et al 2003a) and pulse wave analysis or stroke volume modelling either non-invasively from finger pressure (Eeftinck Schattenkerk et al 2009) or from intra-arterial pressure (Antonutto et al 1994; Harms et al 1999; Nissen et al 2009b) posses the potential to track beat-to-beat changes in stroke volume and in humans as initiated by postural fluid shifts (Fig. 4) (Harms et al 1999).…”

Section: Applications To Clinical Medicinementioning

confidence: 99%

A definition of normovolaemia and consequences for cardiovascular control during orthostatic and environmental stress

2010

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The Frank–Starling mechanism describes the relationship between stroke volume and preload to the heart, or the volume of blood that is available to the heart—the central blood volume. Understanding the role of the central blood volume for cardiovascular control has been complicated by the fact that a given central blood volume may be associated with markedly different central vascular pressures. The central blood volume varies with posture and, consequently, stroke volume and cardiac output () are affected, but with the increased central blood volume during head-down tilt, stroke volume and do not increase further indicating that in the supine resting position the heart operates on the plateau of the Frank–Starling curve which, therefore, may be taken as a functional definition of normovolaemia. Since the capacity of the vascular system surpasses the blood volume, orthostatic and environmental stress including bed rest/microgravity, exercise and training, thermal loading, illness, and trauma/haemorrhage is likely to restrict venous return and . Consequently the cardiovascular responses are determined primarily by their effect on the central blood volume. Thus during environmental stress, flow redistribution becomes dependent on sympathetic activation affecting not only skin and splanchnic blood flow, but also flow to skeletal muscles and the brain. This review addresses the hypothesis that deviations from normovolaemia significantly influence these cardiovascular responses.

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“…In clinical practice a measure of CO is preferably continuous and non-invasive. Non-invasive continuous tracking of changes in SV by ultrasound (US) and arterial pulse wave analysis (Jansen et al 1990;Antonutto et al 1994Antonutto et al , 1995 have the potential to appreciate the importance of systemic blood flow. A general shortcoming with respect to the validation of beat-to-beat tracking of SV is that it is based on a comparison with conventional measurements of SV such as thermodilution-based estimates or inert gas rebreathing which are obtained as averages over at least some 20 heart beats (Hamilton 1948).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2003

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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 (SV(MF)) to Doppler ultrasound (US) flow velocity SV (SV(US)). A second purpose was to compare the two methods under two different conditions: the supine and head-up tilt (30 degrees ) position. SV(US) and SV(MF) 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 degrees 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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Assessment of cardiac output from noninvasive determination of arterial pressure profile in subjects at rest

Cited by 13 publications

References 16 publications

Effects of the muscle pump and body posture on cardiovascular responses during recovery from cycle exercise

Effects of the muscle pump and body posture on cardiovascular responses during recovery from cycle exercise

A definition of normovolaemia and consequences for cardiovascular control during orthostatic and environmental stress

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

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