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KMID : 1144120140040030301
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Biomedical Engineering Letters
2014 Volume.4 No. 3 p.301 ~ p.315
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A comparison of mathematical models of left ventricular contractility derived from aortic blood flow velocity and acceleration: Application to the esophageal doppler monitor
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Atlas Glen
Li John K-J.
Kostis John B.
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Abstract
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Purpose: The esophageal Doppler monitor (EDM) has traditionally been used for minimally-invasive and continuous assessment of both cardiac output and intravascular volume. These measurements are based upon a beat-to-beat analysis of the velocity of distal thoracic aortic blood flow. The purpose of this paper is to compare different mathematical models of LV contractile function which could utilize the EDM and subsequently be determined on a continuous basis.
Methods: This study investigated velocity-based contractility models: peak velocity, (PV); ejection fraction, EF; mean ejection fraction, EF???????? ; and maximum LV radial shortening velocity, max??dRdt?? . Also examined are acceleration-based models: mean acceleration, (MA); force, (F); the maximum rate of rise of systolic arterial blood pressure, max(dPdt) ; and kinetic energy, (KE).
Results: When normalized and subsequently observed on a dimensionless basis, acceleration-based models appear to have a statistically significant greater sensitivity to changes in LV contractility. Furthermore, by combining simultaneous arterial blood pressure measurements with EDM-based flow information, the components of afterload and their effects on LV contractility could be estimated.
Conclusions: Future research is warranted to determine the applicability and limitations of the EDM in continuous assessment of LV contractility and related hemodynamic parameters.
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KEYWORD
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Esophageal Doppler monitor, Cardiac contractility, Force, Kinetic energy, Heart failure, Modeling
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