INSTANTANEOUS MEASUREMENT OF LEFT AND RIGHT VENTRICULAR STROKE VOLUME AND PRESSURE-VOLUME RELATIONSHIPS WITH AN IMPEDANCE CATHETER
INSTANTANEOUS MEASUREMENT OF LEFT AND RIGHT VENTRICULAR STROKE VOLUME AND PRESSURE-VOLUME RELATIONSHIPS WITH AN IMPEDANCE CATHETER
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DOI：
10.1161/01.cir.69.4.703
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发表时间：
1984-01-01
期刊：
影响因子：
37.8
通讯作者：
GROSSMAN, W
中科院分区：
文献类型：
--
作者：
MCKAY, RG;SPEARS, JR;GROSSMAN, W
采用多电极阻抗导管，测量电流为1.3 kHz，测量电流为4µA，对12例心导管插管患者应用连续在线记录的室内阻抗测量每搏输出量的可行性进行了评价，并与10例患者用热稀释技术测定的每搏输出量进行了比较，相关系数为0.95。在整个心动周期中，阻抗记录的方向性变化也与6名患者的放射性核素脑室造影术的容量曲线进行了比较，在所有情况下，两种容量记录之间的一致性都很好。对于所有患者，阻抗的在线测量显示，随着Valsalva动作和亚硝酸戊酯的应用，每搏量逐次减少，而在收缩外搏动后的收缩中，每搏量立即增加。左、右心室的每搏量也有相似的方向变化。同时使用阻抗导管记录的左心室压力和容量信号来评估左心室压力-容量关系，以确定容量的阻抗测量是否可用于临床。随后绘制了压力-容量图，对于所有患者，这些图显示了典型的等容收缩和松弛阶段，以及典型的射血和充盈阶段。在服用亚硝酸戊酯期间，为患者构建的逐拍顺序压力-体积图显示了收缩末期压力-体积的线性关系。腔内电阻抗测量可用于监测患者每搏输出量的瞬时变化，有助于构建压力-容积图和评估左心室收缩末期压力-容量关系。
The feasibility of using continuous on-line recording of intraventricular electrical impedance to measure ventricular stroke volume was assessed in 12 patients at cardiac catheterization with a multielectrode impedance catheter and a 1.3 kHz measuring current of 4 .mu.A. Stroke volumes determined by electrical impedance were compared with stroke volumes determined by the thermodilution technique in 10 patients and correlated with an r value of 0.95. Directional changes in impedance recordings throughout the cardiac cycle were also compared with volume curves obtained from 6 patients by radionuclide ventriculography, and in all instances the agreement between the 2 volume recordings was excellent. For all patients, on-line measurements of impedance showed a beat-by-beat decrease in stroke volume with the Valsalva maneuver and the administration of amyl nitrite, as well as an immediate increase in stroke volume in the contraction following an extra-systolic beat. Similar directional changes in stroke volume were recorded in both left and right ventricles. Left ventricular pressure-volume relationships were assessed with simultaneous left ventricular pressure recordings and volume signals, recorded from the impedance catheter, to determine if impedance measurements of volume can be used clinically. Pressure-volume diagrams were subsequently plotted, and for all patients these diagrams showed characteristic isovolumetric contraction and relaxation phases, as well as typical ejection and filling periods. Beat-by-beat sequential pressure-volume diagrams constructed for patients during the administration of amyl nitrite revealed a linear end-systolic pressure-volume relationship. Measurement of intracavitary electrical impedance can be used to monitor instantaneous changes in stroke volume in patients, and it may be helpful in the construction of presure-volume diagrams and the assessment of left ventricular end-systolic pressure-volume relationships.