Pulse Arrival Time and Pulse Interval as Accurate Markers to Detect Mechanical Alternans

Annals of Biomedical Engineering
Stefan van DuijvenbodenMichele Orini

Abstract

Mechanical alternans (MA) is a powerful predictor of adverse prognosis in patients with heart failure and cardiomyopathy, but its use remains limited due to the need of invasive continuous arterial pressure recordings. This study aims to assess novel cardiovascular correlates of MA in the intact human heart to facilitate affordable and non-invasive detection of MA and advance our understanding of the underlying pathophysiology. Arterial pressure, respiration, and ECG were recorded in 12 subjects with healthy ventricles during voluntarily controlled breathing at different respiratory rate, before and after administration of beta-blockers. MA was induced by ventricular pacing. A total of 67 recordings lasting approximately 90 s each were analyzed. Mechanical alternans (MA) was measured in the systolic blood pressure. We studied cardiovascular correlates of MA, including maximum pressure rise during systole (dPdtmax), pulse arrival time (PAT), pulse wave interval (PI), RR interval (RRI), ECG QRS complexes and T-waves. MA was detected in 30% of the analyzed recordings. Beta-blockade significantly reduced MA prevalence (from 50 to 11%, p < 0.05). Binary classification showed that MA was detected by alternans in dPdtmax (100% sens, 9...Continue Reading

References

Aug 1, 1992·Journal of the American College of Cardiology·B Surawicz, C Fisch
Jan 1, 1981·Psychophysiology·L A GeddesW A Tacker
Jan 27, 1994·The New England Journal of Medicine·David S RosenbaumR J Cohen
Oct 26, 1999·Cardiovascular Research·D E Euler
Mar 20, 2004·Journal of Cardiovascular Electrophysiology·Makoto KodamaYoshifusa Aizawa
Apr 14, 2005·IEEE Transactions on Bio-medical Engineering·Juan Pablo Martinez, Salvador Olmos
Jan 13, 2006·Pacing and Clinical Electrophysiology : PACE·Makoto KodamaYoshifusa Aizawa
Apr 4, 2006·Journal of the American College of Cardiology·Akihiro HirashikiMitsuhiro Yokota
Apr 9, 2008·Progress in Biophysics and Molecular Biology·Kenneth R Laurita, David S Rosenbaum
Apr 23, 2008·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Maria Teresa La RovereGrzegorz Raczak
Oct 19, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Raja J SelvarajVijay S Chauhan
Oct 1, 2011·Journal of Applied Physiology·Guanqun ZhangRamakrishna Mukkamala
Oct 18, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Antonis A ArmoundasFaisal M Merchant
Oct 26, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Violeta MonasterioJuan Pablo Martinez
Aug 8, 2012·IEEE Transactions on Bio-medical Engineering·Jinseok LeeKi H Chon
Sep 13, 2013·Pacing and Clinical Electrophysiology : PACE·Takeshi KashimuraTohru Minamino
Oct 8, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Jihoon KimSeung Woo Park
Nov 16, 2013·IEEE Transactions on Bio-medical Engineering·Michele OriniPier David Lambiase
Oct 18, 2015·American Journal of Physiology. Heart and Circulatory Physiology·Stefan van DuijvenbodenPeter Taggart
Feb 21, 2018·IEEE Transactions on Bio-medical Engineering·Alba Martin-YebraJuan Pablo Martinez
Nov 27, 2018·IEEE Journal of Biomedical and Health Informatics·Tudor BesleagaMichele Orini

Related Concepts

Diastolic Blood Pressure
Myocardial Failure
Pulse Rate
Myocardial Contraction
Pulse Taking
Respiratory Mechanics
Adrenergic beta-Antagonists
Arteries
Biological Markers
Blood Pressure

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