Stroke volume and cardiac output non-invasive monitoring based on brachial oscillometry-derived pulse contour analysis: Explanatory variables and reference intervals throughout life (3–88 years)

Zócalo, Yanina; García-Espinosa, Victoria; Castro, Juan Manuel; Zinoveev, Agustina; Marin, Mariana; Chiesa, Pedro; Díaz, Alejandro; Bia, Daniel

doi:10.5603/cj.a2020.0031

Cited by 23 publications

(32 citation statements)

References 38 publications

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“…The study was carried out in the context of the Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE) project [ 9 , 10 , 11 , 12 , 13 ], a population-based study developed in Uruguay. In this work, we considered data from 3619 subjects included in the CUiiDARTE Database.…”

Section: Methodsmentioning

confidence: 99%

“…CV evaluation in the CUiiDARTE project includes assessing: (i) peripheral (brachial, radial, ankle) and central (aortic, carotid) BP levels; central (aortic, carotid) PWA and WSA-derived parameters (e.g., augmentation index, forward and backward pressure components), (ii) carotid, femoral and brachial beat-to-beat diameter waves and intima-media thickness, (iii) brachial artery reactivity (e.g., flow-mediated dilation; low flow-mediated constriction), (iv) carotid, femoral and brachial doppler-derived blood velocity profiles and resistive/pulsatile indexes, (v) ankle-brachial index, (vi) screening for carotid and femoral atherosclerotic plaques presence, (vii) carotid, femoral and brachial local stiffness (e.g., distensibility, elastic modulus), (viii) systemic hemodynamic evaluation (e.g., systemic vascular resistances, cardiac output and index quantified from brachial pulse contour analysis and/or cardiography impedance, (ix) regional stiffness (cfPWV, crPWV) [ 9 , 10 , 11 , 12 , 13 , 22 ]. In this work, we focused on regional and local PWV data.…”

Section: Methodsmentioning

confidence: 99%

“…Age-related equations were obtained for mean values (MV) and standard deviation (SD). Then, we implemented parametric regression methods based on fractional polynomials (FPs), described by Royston and Wright [ 34 ], included in the European Reference Values for Arterial Measurements Collaboration Group methodological strategy [ 18 , 19 , 20 , 21 ] and already used by our group [ 13 , 35 , 36 , 37 ].…”

Section: Methodsmentioning

confidence: 99%

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Physiological Age- and Sex-Related Profiles for Local (Aortic) and Regional (Carotid-Femoral, Carotid-Radial) Pulse Wave Velocity and Center-to-Periphery Stiffness Gradient, with and without Blood Pressure Adjustments: Reference Intervals and Agreement between Methods in Healthy Subjects (3–84 Years)

Bia

2021

JCDD

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In addition to being a marker of cardiovascular (CV) aging, aortic stiffening has been shown to be independently associated with increased CV risk (directly and/or indirectly due to stiffness-gradient attenuation). Arterial stiffness determines the rate at which the pulse pressure wave propagates (i.e., pulse wave velocity, PWV). Thus, propagated PWV (i.e., the distance between pressure-wave recording sites divided by the pulse transit time) was proposed as an arterial stiffness index. Presently, aortic PWV is considered a gold-standard for non-invasive stiffness evaluation. The limitations ascribed to PWV have hampered its use in clinical practice. To overcome the limitations, different approaches and parameters have been proposed (e.g., local PWV obtained by wave separation and pulse wave analysis). In turn, it has been proposed to determine PWV considering blood pressure (BP) levels (β-PWV), so as to evaluate intrinsic arterial stiffness. It is unknown whether the different approaches used to assess PWV or β-PWV are equivalent and there are few data regarding age- and sex-related reference intervals (RIs) for regional and local PWV, β-PWV and PWV ratio. Aims: (1) to evaluate agreement between data from different stiffness indexes, (2) to determine the need for sex-specific RIs, and (3) to define RIs for PWV, β-PWV and PWV ratio in a cohort of healthy children, adolescents and adults. Methods: 3619 subjects (3–90 y) were included, 1289 were healthy and non-exposed to CV risk factors. Carotid-femoral (cfPWV) and carotid-radial (crPWV) PWV were measured (SphygmoCor System (SCOR)) and PWV ratio (cfPWV/crPWV) was quantified. Local aortic PWV was obtained directly from carotid waves (aoPWV-Carotid; SCOR) and indirectly (generalized transfer function use) from radial (aoPWV-Radial; SCOR) and brachial (aoPWV-Brachial; Mobil-O-Graph system (MOG)) recordings. β-PWV was assessed by means of cardio-ankle brachial (CAVI) and BP-corrected CAVI (CAVIo) indexes. Analyses were done before and after adjustment for BP. Data agreement was analyzed (correlation, Bland-Altman). Mean and standard deviation (age- and sex-related) equations were obtained for PWV parameters (regression methods based on fractional polynomials). Results: The methods and parameters used to assess aortic stiffness showed different association levels. Stiffness data were not equivalent but showed systematic and proportional errors. The need for sex-specific RIs depended on the parameter and/or age considered. RIs were defined for all the studied parameters. The study provides the largest data set related to agreement and RIs for stiffness parameters obtained in a single population.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Physiological Age- and Sex-Related Profiles for Local (Aortic) and Regional (Carotid-Femoral, Carotid-Radial) Pulse Wave Velocity and Center-to-Periphery Stiffness Gradient, with and without Blood Pressure Adjustments: Reference Intervals and Agreement between Methods in Healthy Subjects (3–84 Years)

Bia

2021

JCDD

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“…Systemic vascular resistances (SVRs), cardiac output (CO) and index (CI) were quantified from brachial pulse contour analysis (Mobil-O-Graph, I.E.M.GmbH, Stolberg, Germany) [ 23 ]. Only high-quality records (index ≤2) and satisfactory waves (visual inspection) were considered.…”

Section: Methodsmentioning

confidence: 99%

Changes in Body Size during Early Growth Are Independently Associated with Arterial Properties in Early Childhood

Castro

Marin

Zinoveev

et al. 2021

JCDD

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Nutritional status in early life stages has been associated with arterial parameters in childhood. However, it is still controversial whether changes in standardized body weight (z-BW), height (z-BH), BW for height (z-BWH) and/or body mass index (z-BMI) in the first three years of life are independently associated with variations in arterial structure, stiffness and hemodynamics in early childhood. In addition, it is unknown if the strength of the associations vary depending on the growth period, nutritional characteristics and/or arterial parameters analyzed. Aims: First, to compare the strength of association between body size changes (Δz-BW, Δz-BH, Δz-BWH, Δz-BMI) in different time intervals (growth periods: 0–6, 0–12, 0–24, 0–36, 12–24, 12–36, 24–36 months (m)) and variations in arterial structure, stiffness and hemodynamics at age 6 years. Second, to determine whether the associations depend on exposure to cardiovascular risk factors, body size at birth and/or on body size at the time of the evaluation (cofactors). Anthropometric (at birth, 6, 12, 24, 36 m and at age 6 years), hemodynamic (peripheral and central (aortic)) and arterial (elastic (carotid) and muscular (femoral) arteries; both hemi-bodies) parameters were assessed in a child cohort (6 years; n =632). The association between arterial parameters and body size changes (Δz-BW, Δz-BH, Δz-BWH, Δz-BMI) in the different growth periods was compared, before and after adjustment by cofactors. Results: Δz-BW 0–24 m and Δz-BWH 0–24 m allowed us to explain inter-individual variations in structural arterial properties at age 6 years, with independence of cofactors. When the third year of life was included in the analysis (0–36, 12–36, 24–36 m), Δz-BW explained hemodynamic (peripheral and central) variations at age 6 years. Δz-BH and Δz-BMI showed limited associations with arterial properties. Conclusion: Δz-BW and Δz-BWH are the anthropometric variables with the greatest association with arterial structure and hemodynamics in early childhood, with independence of cofactors.

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“…Computation of LVEF involves cardiac stroke volume which in turn affects the cardiac output. Cardiac output, defined as the amount of blood volume the heart pumps through the systemic circulation over a period measured in liters per minute, 4 is an important measure of cardiac performance providing an indication of systemic oxygen delivery and global tissue perfusion 5,6 . The average cardiac output for a healthy adult is approximately 5–6 L/min, 5 increasing fourfold in untrained individuals, and up to sevenfold in trained athletes 7 …”

Section: Introductionmentioning

confidence: 99%

Comparison of cardiac output estimates by echocardiography and bioreactance at rest and peak dobutamine stress test in heart failure patients with preserved ejection fraction

Sengupta¹,

Mungulmare²,

Okwose³

et al. 2020

Echocardiography

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Purpose: To assess the agreement between cardiac output estimated by two-dimensional echocardiography and bioreactance methods at rest and during dobutamine stress test in heart failure patients with preserved left ventricular ejection fraction (HFpEF). Methods: Hemodynamic measurements were assessed in 20 stable HFpEF patients (12 females; aged 61 ± 7 years) using echocardiography and bioreactance methods during rest and dobutamine stress test at increment dosages of 5, 10, 15, and 20 μg/ kg/min until maximal dose was achieved or symptoms and sign occurred, that is, chest pain, abnormal blood pressure elevation, breathlessness, ischemic changes, or arrhythmia. Results: Resting cardiac output and cardiac index estimated by bioreactance and echocardiography were not significantly different. At peak dobutamine stress test, cardiac output and cardiac index estimated by echocardiography and bioreactance were significantly different (7.06 ± 1.43 vs 5.71 ± 1.59 L/min, P < .01; and 4.27 ± 0.67 vs 3.43 ± 0.87 L/m 2 /min; P < .01) due to the significant differences in stroke volume. There was a strong positive relationship between cardiac outputs obtained by the two methods at peak dobutamine stress (r = .79, P < .01). The mean difference (lower and upper limits of agreement) between bioreactance and echocardiography cardiac outputs at rest and peak dobutamine stress was −0.45 (1.71 to −2.62) L/min and −1.35 (0.60 to −3.31) L/min, respectively. Conclusion: Bioreactance and echocardiography methods provide different cardiac output values at rest and during stress thus cannot be used interchangeably. Ability to continuously monitor key hemodynamic variables such as cardiac output, stroke volume, and heart rate is the major advantage of bioreactance method.

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Stroke volume and cardiac output non-invasive monitoring based on brachial oscillometry-derived pulse contour analysis: Explanatory variables and reference intervals throughout life (3–88 years)

Cited by 23 publications

References 38 publications

Changes in Body Size during Early Growth Are Independently Associated with Arterial Properties in Early Childhood

Comparison of cardiac output estimates by echocardiography and bioreactance at rest and peak dobutamine stress test in heart failure patients with preserved ejection fraction

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