scholarly journals Using the Pulse Contour Method to Measure the Changes in Stroke Volume during a Passive Leg Raising Test

Sensors ◽  
2018 ◽  
Vol 18 (10) ◽  
pp. 3420 ◽  
Author(s):  
Chun-Hung Su ◽  
Shing-Hong Liu ◽  
Tan-Hsu Tan ◽  
Chien-Hsien Lo
Keyword(s):  
Blood Pressure ◽  
Stroke Volume ◽  
Impedance Cardiography ◽  
Pulse Contour ◽  
Passive Leg Raising ◽  
Contour Method ◽  
Blood Pressure Monitor ◽  
Pressure Monitor ◽  
Windkessel Model ◽  
Pulse Contour Method

The pulse contour method is often used with the Windkessel model to measure stroke volume. We used a digital pressure and flow sensors to detect the parameters of the Windkessel model from the pulse waveform. The objective of this study was to assess the stability and accuracy of this method by making use of the passive leg raising test. We studied 24 healthy subjects (40 ± 9.3 years), and used the Medis® CS 1000, an impedance cardiography, as the comparing reference. The pulse contour method measured the waveform of the brachial artery by using a cuff. The compliance and resistance of the peripheral artery was detected from the cuff characteristics and the blood pressure waveform. Then, according to the method proposed by Romano et al., the stroke volume could be measured. This method was implemented in our designed blood pressure monitor. A passive leg raising test, which could immediately change the preloading of the heart, was done to certify the performance of our method. The pulse contour method and impedance cardiography simultaneously measured the stroke volume. The measurement of the changes in stroke volume using the pulse contour method had a very high correlation with the Medis® CS 1000 measurement, the correlation coefficient of the changed ratio and changed differences in stroke volume were r2 = 0.712 and r2 = 0.709, respectively. It was shown that the stroke volume measured by using the pulse contour method was not accurate enough. But, the changes in the stroke volume could be accurately measured with this pulse contour method. Changes in stroke volume are often used to understand the conditions of cardiac preloading in the clinical field. Moreover, the operation of the pulse contour method is easier than using impedance cardiography and echocardiography. Thus, this method is suitable to use in different healthcare fields.

scholarly journals Evaluation of the Pulse-Contour Method of Determining Stroke Volume in Man

Circulation ◽  
1972 ◽  
Vol 46 (3) ◽  
pp. 546-558 ◽  
Author(s):  
EDWIN L. ALDERMAN ◽  
ANGELO BRANZI ◽  
WILLIAM SANDERS ◽  
BYRON W. BROWN ◽  
DONALD C. HARRISON
Keyword(s):  
Stroke Volume ◽  
Pulse Contour ◽  
Contour Method ◽  
Pulse Contour Method

scholarly journals Reflex sympatho-vagal coactivation and concealed QTc prolongation: Lessons from hERG-blockers and long QT syndromes type 1 and type 2

2021 ◽  
Author(s):  
Pascal Champéroux ◽  
Raafat Fares ◽  
Sebastien Jude ◽  
Vincent Maleysson ◽  
Serge Richard ◽  
...  
Keyword(s):  
Stroke Volume ◽  
High Frequency ◽  
Torsades De Pointes ◽  
Pulse Contour ◽  
Contour Method ◽  
Qtc Prolongation ◽  
Compensatory Mechanisms ◽  
Drug Induced ◽  
Vagal Reflex ◽  
Pulse Contour Method

Background and Purposes: Several hERG blocking molecules known for their propensity in triggering Torsades de Pointes (TdP) were reported as increasing High Frequency QT oscillations (HFQT). This effect was found as reflecting a sympatho-vagal coactivation. The present work aims to characterise the mechanism(s) leading to this particular state of the autonomic nervous system. Experimental approach: Effects of 20 hERG blockers including 15 torsadogenic molecules were assessed by telemetry in beagle dogs. Electrocardiogram and stroke volume modelled from the pulse contour method were analysed at the first dose level causing either QTc prolongation and/or HFQT increase. Cardiac autonomic control was analysed using the High Frequency Autonomic Modulation (HFAM) model in dogs and in untreated genotyped LQT1 and LQT2 individuals, for comparison. Key results: The sympatho-vagal coactivation induced by torsadogenic molecules is elicited by reflex compensatory mechanisms in response to changes in stroke volume or cardiac output related to hemodynamic off-targets and/or QT prolongation. QTc prolongation was concealed or markedly blunted by the sympathetic component activation in a large proportion of tested torsadogenic drugs. Sympathetic reflex mechanisms in LQT patients similar to that found for dofetilide was also revealed in both patients exhibiting QTc prolongation and concealed QTc prolongation, irrespective to LQT type. Conclusions and implications: QTc prolongation and/or drug-induced hemodynamic side effects enhance beat to beat ventricular repolarisation variability via sympatho-vagal reflex compensatory mechanisms. Considering the sympathetic reflex component via analysis of HFQT oscillations dramatically improves prediction, sensitivity and specificity of drug induced Torsades de pointes risk assessment.

Initial blood pressure fall on stand up and exercise explained by changes in total peripheral resistance

1991 ◽  
Vol 70 (2) ◽  
pp. 523-530 ◽  
Author(s):  
R. L. Sprangers ◽  
K. H. Wesseling ◽  
A. L. Imholz ◽  
B. P. Imholz ◽  
W. Wieling
Keyword(s):  
Blood Pressure ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Esophageal Pressure ◽  
Pulse Contour ◽  
Contour Method ◽  
Right Atrial ◽  
Gradual Change ◽  
Pulse Contour Method ◽  
Underlying Mechanisms

To elucidate the underlying mechanisms of the initial fall in blood pressure on standing upright from the supine position, we measured the beat-to-beat changes in intra-arterial pressure in eight healthy male subjects in response to standing. Changes in stroke volume, cardiac output, and total peripheral resistance were computed from the pressure waveform using a pulse contour method. To determine possible mechanisms for the changes observed on standing, similar measures were made on passive tilting and a brief (3-s) bout of cycle exercise. Standing elicited a transient 25% (23-mmHg) fall in mean blood pressure as a result of a 36% fall in total peripheral resistance. Head-up tilt elicited a gradual change in haemodynamic parameters, which reached plateau levels in 20-30 s. Cycling elicited a transient 17% (18-mmHg) fall in blood pressure and a 41% fall in total peripheral resistance. In addition, we measured right atrial and esophageal pressures in two subjects on standing and cycling and found a 10- to 15-mmHg rise in right atrial pressure without a corresponding change in esophageal pressure. This points to the cardiopulmonary reflex as the primary effector of peripheral vasodilation, but we cannot exclude the possibility that 1) local metabolic vasodilation and 2) central command-mediated cholinergic vasodilation contributed to the fall in vascular resistance.

scholarly journals Estimation of Stroke Volume in the Dog by a Pulse Contour Method

1970 ◽  
Vol 26 (5) ◽  
pp. 611-623 ◽  
Author(s):  
NICHOLAS T. KOUCHOUKOS ◽  
LOUIS C. SHEPPARD ◽  
DONALD A. McDONALD
Keyword(s):  
Stroke Volume ◽  
Pulse Contour ◽  
Contour Method ◽  
Pulse Contour Method

Study on Cuff-Less Blood Pressure Measurement Based on Electrocardiography and Photoplethysmography Signal

2019 ◽  
Vol 2 (3) ◽  
pp. 206-214
Author(s):  
Putri Indes Oktabriani ◽  
Fuad Ughi ◽  
Aulia Arif Iskandar
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Monitoring ◽  
Blood Pressure Measurement ◽  
Ecg Signal ◽  
Optimum Location ◽  
Blood Pressure Monitor ◽  
Pressure Monitor ◽  
Left Hand ◽  
Measure Blood Pressure

The continuous blood pressure measurement research is widely known for helpingthe development of ambulatory blood pressure monitoring where it measures blood pressureevery 15 to 30 minutes throughout the day. The cuff is a problem for the patient withAmbulatory Blood Pressure Monitor. It can make a person feel uncomfortable and must staystill when the cuff starts to inflate. It is limiting and disturbing their daily activity when thedevice is starting to measure the blood pressure. Blood pressure measurement without cuff isbeing proposed in this research, called cuff-less blood pressure measurement. It will be based onPhotoplethysmography (PPG) and Electrocardiography (ECG) signal analysis. ECG (Lead 1,Lead 2, and Lead 3) with PPG signal produced from index finger on the left hand are comparedand analyzed. Then the relation of PPG and ECG signal and the optimum location for daily usecan be obtained. The optimum location will be based on the electrode’s position that producedthe optimum ECG lead Signal to measure blood pressure. Based on the result, PPG and ECGsignal have a linear relation with Blood Pressure Measurement and Lead 1 is more stable inproducing the ECG signal. The equation from Lead 1 appeared as one of the optimum equationsfor measuring Systolic Blood Pressure (SBP) or Diastolic Blood Pressure (DBP).

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