Continuous stroke volume estimation from aortic pressure using zero dimensional cardiovascular model: proof of concept study from porcine experiments

Type of content
Journal Article
Thesis discipline
Degree name
Publisher
University of Canterbury. Mechanical Engineering
Journal Title
Journal ISSN
Volume Title
Language
Date
2014
Authors
Kamoi, S.
Pretty, C.G.
Docherty, P.D.
Squire, D.
Revie, J.A.
Chiew, Y.S.
Desaive, T.
Shaw, Geoff
Chase, Geoff
Abstract

Introduction

Accurate, continuous, left ventricular stroke volume (SV) measurements can convey large amounts of information about patient hemodynamic status and response to therapy. However, direct measurements are highly invasive in clinical practice, and current procedures for estimating SV require specialized devices and significant approximation.

Method

This study investigates the accuracy of a three element Windkessel model combined with an aortic pressure waveform to estimate SV. Aortic pressure is separated into two components capturing; 1) resistance and compliance, 2) characteristic impedance. This separation provides model-element relationships enabling SV to be estimated while requiring only one of the three element values to be known or estimated. Beat-to-beat SV estimation was performed using population-representative optimal values for each model element. This method was validated using measured SV data from porcine experiments (N = 3 female Pietrain pigs, 29–37 kg) in which both ventricular volume and aortic pressure waveforms were measured simultaneously.

Results

The median difference between measured SV from left ventricle (LV) output and estimated SV was 0.6 ml with a 90% range (5th–95th percentile) −12.4 ml–14.3 ml. During periods when changes in SV were induced, cross correlations in between estimated and measured SV were above R = 0.65 for all cases.

Conclusion

The method presented demonstrates that the magnitude and trends of SV can be accurately estimated from pressure waveforms alone, without the need for identification of complex physiological metrics where strength of correlations may vary significantly from patient to patient.

Description
Citation
Kamoi, S., Pretty, C.G., Docherty, P.D., Squire, D., Revie, J.A., Chiew, Y.S., Desaive, T., Shaw, G.M., Chase, J.G. (2014) Continuous stroke volume estimation from aortic pressure using zero dimensional cardiovascular model: proof of concept study from porcine experiments. PLOS ONE, (in press).
Keywords
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Fields of Research::32 - Biomedical and clinical sciences::3201 - Cardiovascular medicine and haematology::320102 - Haematology
Fields of Research::32 - Biomedical and clinical sciences::3201 - Cardiovascular medicine and haematology::320101 - Cardiology (incl. cardiovascular diseases)
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