Circadian blood pressure and systemic haemodynamics during 42 days of 6° head‐down tilt

Voogel, A. J.; Stok, Wim J.; Pretorius, P. J.; Montfrans, Gert A. van; Langewouters, G.J.; Karemaker, John M.

doi:10.1046/j.1365-201x.1997.00203.x

Cited by 14 publications

(4 citation statements)

References 26 publications

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“…In several reports, invasive calibration was not performed for Modelflow2 assessment of cardiac output, and therefore cardiac output was not expressed as an absolute value but solely as (relative) change in cardiac output [21][22][23][24][25][26]. In other reports, however, MFCO has also been expressed as absolute values [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Finapres arterial pulse wave analysis with Modelflow is not a reliable non-invasive method for assessment of cardiac output

REMMEN¹,

AENGEVAEREN²,

VERHEUGT³

et al. 2002

Clinical Science

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A B S T R A C TNon-invasive continuous monitoring of cardiac output could be very useful in clinical care and in research settings, particularly in elderly subjects. We studied whether Finapres arterial pulse wave analysis with Modelflow2 is a reliable non-invasive method for the assessment of cardiac output in healthy elderly subjects. We compared Modelflow2 cardiac output (MFCO) with thermodilution cardiac output (TDCO) in 28 healthy subjects, aged 70p4 years (meanpS.D.). TDCO was measured during right-sided heart catheterization, while MFCO was calculated with Modelflow2 software from non-invasive arterial Finapres blood pressure, which was measured simultaneously. The two methods were compared using a paired t-test, by Pearson correlation, and by Bland-Altman analysis. TDCO was 6.4p1.1 litres/min (meanpS.D.) and MFCO was 4.7p1.3 litres/min (P 0.001). There was no significant correlation between MFCO and TDCO (r l 0.28, P l 0.13). Mean difference (bias) was k1.7 litres/min (S.E.M. 0.27 litres/min), with an S.D. (precision) of 1.5 litres/min. The 95 % limits of agreement were k4.6 to j1.1 litres/min. In conclusion, non-invasive MFCO values differed significantly from and showed no significant correlation with invasively determined TDCO values in the normal range. Although simple, non-invasive and patient-friendly, the Modelflow2 method is inaccurate for assessment of cardiac output without invasive calibration.

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Section: Discussionmentioning

confidence: 99%

Finapres arterial pulse wave analysis with Modelflow is not a reliable non-invasive method for assessment of cardiac output

REMMEN¹,

AENGEVAEREN²,

VERHEUGT³

et al. 2002

Clinical Science

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“…The finger-cuff device gives a calibrated continuous recording of arterial pressure. It has been used extensively for applications requiring beat-to-beat information such as quantification of baroreceptor function and obstructive sleep apnoea (Bonsignore et al 2002, Omboni et al 1993, Parati et al 1989 as well as in microgravity simulations for space missions (Iwase et al 2000, Voogel et al 1997.…”

Section: Vascular Unloading Methods the Volume Clamp Or Vascular Unlo...mentioning

confidence: 99%

Arterial blood pressure measurement and pulse wave analysis-–their role in enhancing cardiovascular assessment

2009

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The most common method of clinical measurement of arterial blood pressure is by means of the cuff sphygmomanometer. This instrument has provided fundamental quantitative information on arterial pressure in individual subjects and in populations and facilitated estimation of cardiovascular risk related to levels of blood pressure obtained from the brachial cuff. Although the measurement is taken in a peripheral limb, the values are generally assumed to reflect the pressure throughout the arterial tree in large conduit arteries. Since the arterial pressure pulse becomes modified as it travels away from the heart towards the periphery, this is generally true for mean and diastolic pressure, but not for systolic pressure, and so pulse pressure. The relationship between central and peripheral pulse pressure depends on propagation characteristics of arteries. Hence, while the sphygmomanometer gives values of two single points on the pressure wave (systolic and diastolic pressure), there is additional information that can be obtained from the time-varying pulse waveform that enables an improved quantification of the systolic load on the heart and other central organs. This topical review will assess techniques of pressure measurement that relate to the use of the cuff sphygmomanometer and to the non-invasive registration and analysis of the peripheral and central arterial pressure waveform. Improved assessment of cardiovascular function in relation to treatment and management of high blood pressure will result from future developments in the indirect measurement of arterial blood pressure that involve the conventional cuff sphygmomanometer with the addition of information derived from the peripheral arterial pulse.

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“…Several research groups have monitored BP and HR during periods of extended bed-rest in healthy subjects (Hartikainen et al 1993;Shiraishi et al 2003;Voogel et al 1997). In such studies, sleep is taken but physical activity is prevented.…”

Section: Exogenous and Endogenous Components Of The Circadian Rhythmsmentioning

confidence: 99%

Chronophysiology of the cardiovascular system

Waterhouse

Atkinson

Reilly

et al. 2007

Biological Rhythm Research

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The development of ambulatory blood pressure monitoring devices and the beat-by-beat measurement of heart rate have enabled it to be established that there are circadian rhythms in heart rate and blood pressure in subjects living normally. Investigations of these variables have led to quantification of their fall at night, and rapid rise on awakening and becoming active in the morning. These changes are of particular interest insofar as abnormalities in them are associated with cardiovascular problems and morbidity in patients and also act as risk factors in otherwise healthy individuals. It has also been shown that there are many other variables of the cardiovascular system. The causes of the circadian rhythms in heart rate and blood pressure are outlined, with particular stress upon the role of the autonomic nervous system, as assessed from low-and high-frequency components of the variation in heart rate measured beat-by-beat. Activity increases blood pressure, but there is evidence that this ''reactivity'' varies with time of day, and this also might be related to cardiovascular morbidity. Based upon data from several sources, including night work, resting subjects and bed-ridden patients, it is concluded that the contribution of the ''body clock'' to producing the circadian rhythm in heart rate and blood pressure is relatively small. A bias towards an exogenous cause applies also to most other circadian rhythms in the cardiovascular system. Knowledge of circadian rhythmicity in cardiovascular system, together with an understanding of its causes, provides a rationale for advice to reduce cardiovascular risk and to assess the efficacy of therapies.

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Circadian blood pressure and systemic haemodynamics during 42 days of 6° head‐down tilt

Cited by 14 publications

References 26 publications

Finapres arterial pulse wave analysis with Modelflow is not a reliable non-invasive method for assessment of cardiac output

Finapres arterial pulse wave analysis with Modelflow is not a reliable non-invasive method for assessment of cardiac output

Arterial blood pressure measurement and pulse wave analysis-–their role in enhancing cardiovascular assessment

Chronophysiology of the cardiovascular system

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