Arterial Pressure; Electric Capacitance; Electrocardiography; Feasibility Studies; Heart Rate; Humans; Male; Patient-Specific Modeling; Signal Processing, Computer-Assisted; Systole/physiology; Time Factors; Ventricular Function, Left; Cardiovascular system; Minimally invasive; Time varying elastance
Abstract :
[en] BACKGROUND: The aim of this paper was to establish a minimally invasive method for deriving the left ventricular time varying elastance (TVE) curve beat-by-beat, the monitoring of which's inter-beat evolution could add significant new data and insight to improve diagnosis and treatment. The method developed uses the clinically available inputs of aortic pressure, heart rate and baseline end-systolic volume (via echocardiography) to determine the outputs of left ventricular pressure, volume and dead space volume, and thus the TVE curve. This approach avoids directly assuming the shape of the TVE curve, allowing more effective capture of intra- and inter-patient variability. RESULTS: The resulting TVE curve was experimentally validated against the TVE curve as derived from experimentally measured left ventricular pressure and volume in animal models, a data set encompassing 46,318 heartbeats across 5 Pietrain pigs. This simulated TVE curve was able to effectively approximate the measured TVE curve, with an overall median absolute error of 11.4% and overall median signed error of -2.5%. CONCLUSIONS: The use of clinically available inputs means there is potential for real-time implementation of the method at the patient bedside. Thus the method could be used to provide additional, patient specific information on intra- and inter-beat variation in heart function.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Davidson, Shaun
Pretty, Chris
Pironet, Antoine
Kamoi, Shun
Balmer, Joel
Desaive, Thomas ; Université de Liège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
Chase, J. Geoffrey
Language :
English
Title :
Minimally invasive, patient specific, beat-by-beat estimation of left ventricular time varying elastance.
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