呼吸门控改善了实验性肺动脉高压患者脉搏波通过时间与肺动脉压力之间的相关性。

IF 2.3 4区 医学 Q3 BIOPHYSICS Physiological measurement Pub Date : 2024-03-29 DOI:10.1088/1361-6579/ad2eb5
Fabian Mueller-Graf, Paul Frenkel, Jonas Merz, Susanne Reuter, Brigitte Vollmar, Gerardo Tusman, Sven Pulletz, Stephan H Böhm, Amelie Zitzmann, Daniel A Reuter, Andy Adler
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引用次数: 0

摘要

由于脉搏波转运时间(PWTT)会随着肺动脉压(PAP)的增加而缩短,因此被认为是肺动脉压的潜在无创替代指标。众所周知,潮气肺充盈状态也会影响 PWTT,而与 PAP 无关。这项回顾性分析的目的是检验呼吸门控是否改善了 PWTT 和 PAP 之间的相关系数。在五头麻醉和机械通气的猪身上分别放置了两根高保真压力导管,一根直接位于肺动脉瓣后方,另一根位于肺动脉远端分支。使用血栓素 A2 类似物 U46619 提高血压,并以压力控制模式(I:E 比为 1:2,呼吸频率为 12/分钟,潮气量为 6 毫升/千克)对动物进行通气。所有信号均使用多通道平台 PowerLab® 进行记录。使用基于 MATLAB 的修正双曲正切算法确定脉搏波到达每个导管尖端的时间,并将 PWTT 计算为这些到达之间的时间间隔。对于血栓素,PWTT 与平均 PAP 的相关系数为 r = 0.932。当选择呼气末(r = 0.978)或呼气末(r = 0.985)的心脏搏动时(= 呼吸门控),该相关系数显著增加。因此,在考虑呼吸周期的情况下,通过脉搏波速度来估算平均肺活量的效果显著提高。建议呼吸门控可改善脉搏波速度测试法对 PAP 的估计。
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Respiratory gating improves correlation between pulse wave transit time and pulmonary artery pressure in experimental pulmonary hypertension.

Objective. Since pulse wave transit time (PWTT) shortens as pulmonary artery pressure (PAP) increases it was suggested as a potential non-invasive surrogate for PAP. The state of tidal lung filling is also known to affect PWTT independently of PAP. The aim of this retrospective analysis was to test whether respiratory gating improved the correlation coefficient between PWTT and PAP.Approach. In each one of five anesthetized and mechanically ventilated pigs two high-fidelity pressure catheters were placed, one directly behind the pulmonary valve, and the second one in a distal branch of the pulmonary artery. PAP was raised using the thromboxane A2 analogue U46619 and animals were ventilated in a pressure controlled mode (I:E ratio 1:2, respiratory rate 12/min, tidal volume of 6 ml kg-1). All signals were recorded using the multi-channel platform PowerLab®. The arrival of the pulse wave at each catheter tip was determined using a MATLAB-based modified hyperbolic tangent algorithm and PWTT calculated as the time interval between these arrivals.Main results. Correlation coefficient for PWTT and mean PAP wasr= 0.932 for thromboxane. This correlation coefficient increased considerably when heart beats either at end-inspiration (r= 0.978) or at end-expiration (r= 0.985) were selected (=respiratory gating).Significance. The estimation of mean PAP from PWTT improved significantly when taking the respiratory cycle into account. Respiratory gating is suggested to improve for the estimation of PAP by PWTT.

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来源期刊
Physiological measurement
Physiological measurement 生物-工程:生物医学
CiteScore
5.50
自引率
9.40%
发文量
124
审稿时长
3 months
期刊介绍: Physiological Measurement publishes papers about the quantitative assessment and visualization of physiological function in clinical research and practice, with an emphasis on the development of new methods of measurement and their validation. Papers are published on topics including: applied physiology in illness and health electrical bioimpedance, optical and acoustic measurement techniques advanced methods of time series and other data analysis biomedical and clinical engineering in-patient and ambulatory monitoring point-of-care technologies novel clinical measurements of cardiovascular, neurological, and musculoskeletal systems. measurements in molecular, cellular and organ physiology and electrophysiology physiological modeling and simulation novel biomedical sensors, instruments, devices and systems measurement standards and guidelines.
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