Portal de Periódicos da CAPES

MEASUREMENT OF CARDIAC OUTPUT BY NON-INVASIVE CONTINUOUS WHOLE-BODY BIOIMPEDANCE CARDIOGRAPHY IN PATIENTS WITH AORTIC STENOSIS

2014; Elsevier BV; Volume: 30; Issue: 10 Linguagem: Inglês

10.1016/j.cjca.2014.07.380

1916-7075

Carrie Fung, Rhonda M. Williams, B. Tyrrell,

Congenital Heart Disease Studies

BackgroundNon Invasive Cardiac System (NICaS) (NI Medical; Hod-Hasharon, Israel) is a noninvasive, continuous whole-body bioimpedance device to assess cardiac output (CO) by measuring change in bioimpedance. The use of this device for CO measurement has been validated with thermodilution in various clinical settings such as coronary bypass grafting, acute heart failure. The aim of this study is to validate the use of NICaS in estimating CO in patients with moderate to severe aortic stenosis (AS).MethodsConsecutive patients undergoing hemodynamic assessment of AS for possible percutanous or surgical aortic valve replacement in our catheterization laboratory from 1 April 2014 were recruited. CO was measured by both therrmodilution and NICaS. The procedures were performed by two independent blinded operators. Patients with significant peripheral vascular disease, body mass index > 40, renal dialysis, significant peripheral oedema, height under 1.5m and above 2.0m, significant severe aortic / mitral regurgitation, congenital cardiac malformations and extracardiac shunts were excluded. The mean of three to six sets of CO measurements from both Methods within the same time period were obtained. The paired values were analyzed for correlation and limit of agreement according to the Bland and Altman methodology. Differences between paired mean values were analyzed with the Student's t-test.ResultsA total of 8 patients were included in the study. We are targeting to recruit a total of 40-50 patients by early September this year. The mean catheterization and echocardiographic aortic valve areas were 0.74±0.12 cm2 and 0.87±0.15 cm2 respectively. The overall correlation between the NICaS CO and the thermodilution CO was r = 0.82 (p= 0.013) (Fig 1). The limits of agreement (2SD) were -2.26 and 1.46 L/min (Fig 2). The mean NICaS CO and thermodilution CO were 5.58±1.55 L/min and 5.18±1.54 L/min respectively. The mean difference (bias) was -0.40±0.93 L/min (p=0.26).Conclusion BackgroundNon Invasive Cardiac System (NICaS) (NI Medical; Hod-Hasharon, Israel) is a noninvasive, continuous whole-body bioimpedance device to assess cardiac output (CO) by measuring change in bioimpedance. The use of this device for CO measurement has been validated with thermodilution in various clinical settings such as coronary bypass grafting, acute heart failure. The aim of this study is to validate the use of NICaS in estimating CO in patients with moderate to severe aortic stenosis (AS). Non Invasive Cardiac System (NICaS) (NI Medical; Hod-Hasharon, Israel) is a noninvasive, continuous whole-body bioimpedance device to assess cardiac output (CO) by measuring change in bioimpedance. The use of this device for CO measurement has been validated with thermodilution in various clinical settings such as coronary bypass grafting, acute heart failure. The aim of this study is to validate the use of NICaS in estimating CO in patients with moderate to severe aortic stenosis (AS). MethodsConsecutive patients undergoing hemodynamic assessment of AS for possible percutanous or surgical aortic valve replacement in our catheterization laboratory from 1 April 2014 were recruited. CO was measured by both therrmodilution and NICaS. The procedures were performed by two independent blinded operators. Patients with significant peripheral vascular disease, body mass index > 40, renal dialysis, significant peripheral oedema, height under 1.5m and above 2.0m, significant severe aortic / mitral regurgitation, congenital cardiac malformations and extracardiac shunts were excluded. The mean of three to six sets of CO measurements from both Methods within the same time period were obtained. The paired values were analyzed for correlation and limit of agreement according to the Bland and Altman methodology. Differences between paired mean values were analyzed with the Student's t-test. Consecutive patients undergoing hemodynamic assessment of AS for possible percutanous or surgical aortic valve replacement in our catheterization laboratory from 1 April 2014 were recruited. CO was measured by both therrmodilution and NICaS. The procedures were performed by two independent blinded operators. Patients with significant peripheral vascular disease, body mass index > 40, renal dialysis, significant peripheral oedema, height under 1.5m and above 2.0m, significant severe aortic / mitral regurgitation, congenital cardiac malformations and extracardiac shunts were excluded. The mean of three to six sets of CO measurements from both Methods within the same time period were obtained. The paired values were analyzed for correlation and limit of agreement according to the Bland and Altman methodology. Differences between paired mean values were analyzed with the Student's t-test. ResultsA total of 8 patients were included in the study. We are targeting to recruit a total of 40-50 patients by early September this year. The mean catheterization and echocardiographic aortic valve areas were 0.74±0.12 cm2 and 0.87±0.15 cm2 respectively. The overall correlation between the NICaS CO and the thermodilution CO was r = 0.82 (p= 0.013) (Fig 1). The limits of agreement (2SD) were -2.26 and 1.46 L/min (Fig 2). The mean NICaS CO and thermodilution CO were 5.58±1.55 L/min and 5.18±1.54 L/min respectively. The mean difference (bias) was -0.40±0.93 L/min (p=0.26). A total of 8 patients were included in the study. We are targeting to recruit a total of 40-50 patients by early September this year. The mean catheterization and echocardiographic aortic valve areas were 0.74±0.12 cm2 and 0.87±0.15 cm2 respectively. The overall correlation between the NICaS CO and the thermodilution CO was r = 0.82 (p= 0.013) (Fig 1). The limits of agreement (2SD) were -2.26 and 1.46 L/min (Fig 2). The mean NICaS CO and thermodilution CO were 5.58±1.55 L/min and 5.18±1.54 L/min respectively. The mean difference (bias) was -0.40±0.93 L/min (p=0.26). Conclusion