Purpose

Through pulse contour analysis (PCA) devices would enable to obtain non-invasive operator-independent cardiac output (CO) measurements [CO(PCA)]. The agreement between CO(PCA) and data from two-dimensional [CO(2D)] or Doppler [CO(VTI)] echocardiography (references) remains controversial.

Aims

To analyze: (1) CO(PCA), CO(2D) and CO(VTI) agreement, (2) determinants of methods’ differences in measured CO values.

Methods

Simultaneous echocardiography and PCA records (Mobil-O-Graph/Germany) were obtained in 130 subjects (age: 29 ± 17 years). Hemodynamic (e.g., heart rate [HR]), arterial (e.g., arterial stiffness, augmentation index [AIx]) and cardiac structural–functional (e.g., left ventricle end-diastolic diameters [LVEDD]) parameters were obtained. Data from the entire group (all; 10–85 years), children (≤ 16 years), adolescents (17–24 years) and adults (> 24 years) were separately analyzed.

Results

The highest Lin’s concordance correlation coefficient (CCC) were obtained when analyzing CO(PCA)/CO(2D) association (0.672, 0.785, 0.721, 0.487 for all, children, adolescents and adults, respectively); CCC levels were higher at younger ages. Bland–Altman’s systematic errors between CO(PCA)/CO(2D) were 0.12, 0.17, 0.07 and 0.14 L/min, for all, children, adolescents and adults, respectively (non-significant). CO(VTI)/CO(PCA) systematic error only reached significance in adults (0.34 L/min, p = 0.002). Bland–Altman’s proportional errors were not statistically significant when CO(PCA)/CO(2D) differences were analysed in children and adolescents. Higher AIx and LVEDD levels associated greater CO(2D)/CO(PCA) differences; higher AIx and HR levels were associated to differences between CO(VTI) and CO(PCA).

Conclusion

CO(PCA) had systematic (< 0.17 L/min) and percent (≤ 30%) errors, which allow us to postulate that its use allows reaching levels comparable to those of echocardiography. Differences in CO-data between methods were associated with arterial and cardiac properties.

中文翻译：

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基于脉搏轮廓分析的儿童，青少年和成人的心输出量监测：与超声心动图得出的数据进行比较，并确定与它们的差异相关的因素。

目的

通过脉搏轮廓分析（PCA）设备将能够获得无创操作者无关的心输出量（CO）测量值[CO（PCA）]。CO（PCA）与二维[CO（2D）]或多普勒[CO（VTI）]超声心动图（参考）数据之间的协议仍存在争议。

目的

要分析：（1）CO（PCA），CO（2D）和CO（VTI）协议，（2）确定测量的CO值中方法差异的决定因素。

方法

在130位受试者（年龄：29±17岁）中获得了同时的超声心动图和PCA记录（Mobil-O-Graph /德国）。获得了血流动力学（例如，心率[HR]），动脉（例如，动脉刚度，增强指数[AIx]）和心脏结构功能（例如，左心室舒张末期直径[LVEDD]）参数。分别分析了整个组（全部； 10-85岁），儿童（≤16岁），青少年（17-24岁）和成人（> 24岁）的数据。

结果

分析CO（PCA）/ CO（2D）关联时，林氏一致性相关系数最高（CCC）（儿童，青少年和成人分别为0.672、0.785、0.721、0.487）；幼儿的CCC水平较高。对于所有儿童，青少年和成人，Bland–Altman的CO（PCA）/ CO（2D）系统误差分别为0.12、0.17、0.07和0.14 L / min（无统计学意义）。CO（VTI）/ CO（PCA）系统误差仅在成年人中才有意义（0.34 L / min，p  = 0.002）。当分析儿童和青少年的CO（PCA）/ CO（2D）差异时，布兰特-奥尔特曼的比例误差没有统计学意义。较高的AIx和LVEDD水平与较大的CO（2D）/ CO（PCA）差异相关；较高的AIx和HR水平与CO（VTI）和CO（PCA）之间的差异有关。

结论

CO（PCA）具有系统性（<0.17 L / min）和百分比（≤30％）的误差，这使我们可以假定其使用可以达到与超声心动图可比的水平。方法之间的CO数据差异与动脉和心脏特性有关。