Cardiac power output accurately reflects external cardiac work over a wide range of inotropic states in pigs
Standard
Cardiac power output accurately reflects external cardiac work over a wide range of inotropic states in pigs. / Abawi, Dawud; Faragli, Alessandro; Schwarzl, Michael; Manninger, Martin; Zweiker, David; Kresoja, Karl-Patrik; Verderber, Jochen; Zirngast, Birgit; Maechler, Heinrich; Steendijk, Paul; Pieske, Burkert; Post, Heiner; Alogna, Alessio.
In: BMC CARDIOVASC DISOR, Vol. 19, No. 1, 15.10.2019, p. 217.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Cardiac power output accurately reflects external cardiac work over a wide range of inotropic states in pigs
AU - Abawi, Dawud
AU - Faragli, Alessandro
AU - Schwarzl, Michael
AU - Manninger, Martin
AU - Zweiker, David
AU - Kresoja, Karl-Patrik
AU - Verderber, Jochen
AU - Zirngast, Birgit
AU - Maechler, Heinrich
AU - Steendijk, Paul
AU - Pieske, Burkert
AU - Post, Heiner
AU - Alogna, Alessio
PY - 2019/10/15
Y1 - 2019/10/15
N2 - BACKGROUND: Cardiac power output (CPO), derived from the product of cardiac output and mean aortic pressure, is an important yet underexploited parameter for hemodynamic monitoring of critically ill patients in the intensive-care unit (ICU). The conductance catheter-derived pressure-volume loop area reflects left ventricular stroke work (LV SW). Dividing LV SW by time, a measure of LV SW min- 1 is obtained sharing the same unit as CPO (W). We aimed to validate CPO as a marker of LV SW min- 1 under various inotropic states.METHODS: We retrospectively analysed data obtained from experimental studies of the hemodynamic impact of mild hypothermia and hyperthermia on acute heart failure. Fifty-nine anaesthetized and mechanically ventilated closed-chest Landrace pigs (68 ± 1 kg) were instrumented with Swan-Ganz and LV pressure-volume catheters. Data were obtained at body temperatures of 33.0 °C, 38.0 °C and 40.5 °C; before and after: resuscitation, myocardial infarction, endotoxemia, sevoflurane-induced myocardial depression and beta-adrenergic stimulation. We plotted LVSW min- 1 against CPO by linear regression analysis, as well as against the following classical indices of LV function and work: LV ejection fraction (LV EF), rate-pressure product (RPP), triple product (TP), LV maximum pressure (LVPmax) and maximal rate of rise of LVP (LV dP/dtmax).RESULTS: CPO showed the best correlation with LV SW min- 1 (r2 = 0.89; p < 0.05) while LV EF did not correlate at all (r2 = 0.01; p = 0.259). Further parameters correlated moderately with LV SW min- 1 (LVPmax r2 = 0.47, RPP r2 = 0.67; and TP r2 = 0.54). LV dP/dtmax correlated worst with LV SW min- 1 (r2 = 0.28).CONCLUSION: CPO reflects external cardiac work over a wide range of inotropic states. These data further support the use of CPO to monitor inotropic interventions in the ICU.
AB - BACKGROUND: Cardiac power output (CPO), derived from the product of cardiac output and mean aortic pressure, is an important yet underexploited parameter for hemodynamic monitoring of critically ill patients in the intensive-care unit (ICU). The conductance catheter-derived pressure-volume loop area reflects left ventricular stroke work (LV SW). Dividing LV SW by time, a measure of LV SW min- 1 is obtained sharing the same unit as CPO (W). We aimed to validate CPO as a marker of LV SW min- 1 under various inotropic states.METHODS: We retrospectively analysed data obtained from experimental studies of the hemodynamic impact of mild hypothermia and hyperthermia on acute heart failure. Fifty-nine anaesthetized and mechanically ventilated closed-chest Landrace pigs (68 ± 1 kg) were instrumented with Swan-Ganz and LV pressure-volume catheters. Data were obtained at body temperatures of 33.0 °C, 38.0 °C and 40.5 °C; before and after: resuscitation, myocardial infarction, endotoxemia, sevoflurane-induced myocardial depression and beta-adrenergic stimulation. We plotted LVSW min- 1 against CPO by linear regression analysis, as well as against the following classical indices of LV function and work: LV ejection fraction (LV EF), rate-pressure product (RPP), triple product (TP), LV maximum pressure (LVPmax) and maximal rate of rise of LVP (LV dP/dtmax).RESULTS: CPO showed the best correlation with LV SW min- 1 (r2 = 0.89; p < 0.05) while LV EF did not correlate at all (r2 = 0.01; p = 0.259). Further parameters correlated moderately with LV SW min- 1 (LVPmax r2 = 0.47, RPP r2 = 0.67; and TP r2 = 0.54). LV dP/dtmax correlated worst with LV SW min- 1 (r2 = 0.28).CONCLUSION: CPO reflects external cardiac work over a wide range of inotropic states. These data further support the use of CPO to monitor inotropic interventions in the ICU.
KW - Adrenergic beta-Agonists/pharmacology
KW - Animals
KW - Disease Models, Animal
KW - Dobutamine/pharmacology
KW - Endotoxemia/physiopathology
KW - Heart Failure/diagnosis
KW - Hyperthermia, Induced
KW - Hypothermia, Induced
KW - Myocardial Infarction/diagnosis
KW - Resuscitation
KW - Sevoflurane/pharmacology
KW - Stroke Volume/drug effects
KW - Sus scrofa
KW - Time Factors
KW - Ventricular Fibrillation/diagnosis
KW - Ventricular Function, Left/drug effects
KW - Ventricular Pressure/drug effects
U2 - 10.1186/s12872-019-1212-2
DO - 10.1186/s12872-019-1212-2
M3 - SCORING: Journal article
C2 - 31615415
VL - 19
SP - 217
JO - BMC CARDIOVASC DISOR
JF - BMC CARDIOVASC DISOR
SN - 1471-2261
IS - 1
ER -