The pilot study of role of electrical cardiometry in non‑invasive assessment of hemodynamic parameters in patients with pulmonary arterial hypertension (RCD code: II‑1A.1)

Remigiusz Kazimierczyk, Małgorzata Jasiewicz, Marta Marcinkiewicz-Siemion, Małgorzata Knapp, Anna Lisowska, Piotr Błaszczak, Bożena Sobkowicz, Włodzimierz Jerzy Musiał, Ryszard Grzywna, Karol Adam Kamiński

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Abstract


Background: Electrical cardiometry (EC) technique could estimate cardiac output (CO), cardiac index (CI) and other parameters related to cardiac contractility and fluid status by measuring the thoracic electrical bioimpedance. We hypothesized that EC could assess right ventricle (RV) hemodynamic function in patients diagnosed with pulmonary arterial hypertension (PAH). Results: In our pilot study, enrolling 23 PAH patients, we observed a significant correlation (r = 0.71; p <0.001) between thermodilution CO measurement results (4.59 ±1.05 l/min) and CO results obtained by EC (4.86 ±1.20 l/min) and between systemic vascular resistance calculated by EC monitor and obtained during right heart catheterization (RHC) (r = 0.68; p = 0.002). Furthermore, EC parameter index of contractility (ICON) sig‑ nificantly correlated with tricuspid annular plane systolic excursion assessed by echocardiography (r = 0.57; p = 0.01). Conclusions: RHC cannot be replaced in obtaining accurate results of CO, however EC technique provides feasible insight into RV function at the bedside or outpatient care. JRCD 2017; 3 (2): 44–49


Keywords


rare disease; electrical cardiometry; right heart catheterization; pulmonary arterial hypertension; hemodynamic measurements

References


Yancy C, Abraham W. Noninvasive hemodynamic monitoring in heart failure: Utilization of impedance cardiography. Congest Heart Fail 2003: 9: 241–250.

Pranulis M. Impedance cardiography noninvasive hemodynamic monitoring provides as opportunity to deliver cost effective quality care for patients with cardiovascular disorders. J Cardiovasc Manag 2000; 11: 13–17.

Galiè N, Humbert M, Vachiery JL, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart Journal 2016; 37: 67-119.

Woltjer HH, Bogaard HJ, de Vries PM. The technique of impedance cardiography. Eur Heart J 1997; 18: 1396–1403.

WINDOW TO THE CIRCULATION® Electrical Cardiometry™ Validations & Clinical Research. Retrived from http://www.osypkamed.com/sites/default/ files/public_resources/EC_Scientific_Articles_booklet.pdf

Bergstra A, Van Dijk RB, Hillege HL, et al. Assumed oxygen consumption based on calculation from dye dilution cardiac output: an improved formula. EurHeart J 1995; 16 698–703.

Berger M, Haimowitz A, Van Tosh A, et al. Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound. J Am Coll Cardiol 1985; 6: 359–365.

Sandham JD, Hull RD, Brandt RF, et al. A randomized, controlled trial of the use of pulmonary‑artery‑catheters in high‑risk surgical patients. N Engl J Med 2003; 348: 5–14.

Tuman KJ, McCarthy RJ, Spiess BD, et al. Effect of pulmonary artery catheterization on outcome in patients undergoing coronary artery surgery. Anesthesiology 1989; 70: 199–206.

Connors AF, Speroff T, Dawson NV, et al. The effectiveness of right heart catheterization in the initial care of critically ill patients. J Am Med Assoc 1996; 276: 889–897.

Cross SJ, Lee HS, Jennings K, Rawles J. Measurement of cardiac output with the Quantascope, a novel Doppler device: comparison with thermodilution. Eur Heart J 1993; 14: 809–811.

Capek JM, Roy RJ. Noninvasive measurement of cardiac output using partial CO2 rebreathing. IEEE Trans Biomed Eng 1988; 35: 653–661.

Kubicek WG, Karnegis JN, Patterson RP, et al. Development and evaluation of an impedance cardiac output system. Aerosp Med 1966; 37: 1208–1212.

Moshkovitz Y, Kaluski E, Milo O, et al. Recent developments in cardiac output determination by bioimpedance: comparison with invasive cardiac output and potential cardiovascular applications. Curr Opin Cardiol 2004; 19: 229–237.

Osypka MJ, Bernstein DP. Electrophysiologic principles and theory of stroke volume determination by thoracic electrical bioimpedance. AACN Clin Issues 1999; 10: 385–399.

Appel PL, Kram HB, Mackabee J, et al. Comparison of measurements of cardiac output by bioimpedance and thermodilution in severely ill surgical patients. Crit Care Med 1966; 14: 933–935.

Sageman WS, Amundson DE. Thoracic electrical bioimpedance measurements of cardiac output in postaortocoronary bypass patients. Crit Care Med 1993; 21: 1139–1142.

Liu YH, Dhakal BP, Keesakul C, et al. Continuous non‑invasive cardiac output monitoring during exercise: validation of electrical cardiometry with Fick and thermodilution methods Br J Anaesth 2016; 117: 129–141.

Zoremba N, Bickenbach J, Krauss B, et al. Comparison of electrical velocimetry and thermodilution techniques for the measurement of cardiac output. Acta Anaesthesiol Scand 2007; 51: 1314–1319.

Van de Water JM, Mount BE, Chandra KM, et al: TFC (thoracic fluid content): A new parameter for assessment of changes in chest fluid volume. Am Surg 2005; 71: 81–86.

Kang WS, Lee JH, Shin HJ, et al: Noninvasive cardiac output monitoring in paediatric cardiac surgery: Correlation between change in thoracic fluid content and change in patient body weight. J Int Med Res 2012; 40: 2295–2304.

Sanidas EA, Grammatikopoulos K, Anastasiadis G, et al: Thoracic fluid content and impedance cardiography: A novel and promising noninvasive method for assessing the hemodynamic effects of diuretics in hypertensive patients. Hellenic J Cardiol 2009; 50: 465–471.

Narula J, Kiran U, Chauhan S, et al: Electrical cardiometry in patients undergoing cardiac catheterisation. Int J Periop Ultrasound Appl Technol 2013; 2: 102–107.

Suttner S, Schöllhorn T, Boldt J, et al. Noninvasive assessment of cardiac output using thoracic electrical bioimpedance in hemodynamically stable and unstable patients after cardiac surgery: a comparison with pulmonary artery thermodilution. Intensive Care Med 2006; 32: 2053–2062.

Pranulis M: Impedance cardiography noninvasive hemodynamic monitoring provides as opportunity to deliver cost effective quality care for patients with cardiovascular disorders. J Cardiovasc Manag 2000; 11: 13–17




DOI: http://dx.doi.org/10.20418%2Fjrcd.vol3no2.270

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