利用新技术实现颈动脉血流校正时间与左心室流出道速度-时间积分之间的相关性

IF 1.2 4区 医学 Q3 ACOUSTICS Journal of Clinical Ultrasound Pub Date : 2024-09-18 DOI:10.1002/jcu.23838
Issac Cheong, Pablo Martín Merlo, Francisco Marcelo Tamagnone
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引用次数: 0

摘要

背景经胸超声心动图(TTE)被广泛用于重症监护病房的患者评估,其中心输出量测量对血流动力学监测至关重要。通过测量左心室流出道(LVOT)的速度-时间积分(VTI)可实现这一目的,VTI 可作为每搏量的代用指标。然而,在重症监护环境中进行 TTE 会面临一些挑战。我们的主要目的是研究颈动脉校正血流时间(cCFT)与左心室流出道 VTI 之间的关系。此外,我们还旨在确定能可靠预测 LVOT VTI 正常的 cCFT 临界值。材料和方法这项概念验证研究涉及在内外科重症监护病房进行的诊断准确性调查的事后分析。我们纳入了 2021 年 12 月至 2022 年 1 月入住重症监护室的患者。我们使用相控阵传感器测量左锁骨上窝的 cCFT 和心尖五腔切面的 LVOT VTI。LVOT VTI 与 cCFT 之间的 Spearman 系数为 0.82(p < 0.0001)。cCFT 预测 LVOT VTI 等于或大于 17 cm 的 ROC 曲线下面积为 0.871(95% CI 0.660-0.974)。超过 283 毫秒的 cCFT 预测 LVOT VTI 等于或大于 17 厘米的灵敏度为 93.3%(95% CI 68.1% 至 99.8%),特异度为 85.7%(95% CI 42.1% 至 99.6%)。此外,cCFT 还能预测重症患者左心室出口 VTI 是否正常,并具有良好的敏感性和特异性。需要进行更大规模的研究来验证这些发现。
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Correlation between corrected carotid flow time and left ventricular outflow tract velocity‐time integral using a novel technique
BackgroundTransthoracic echocardiography (TTE) is widely used for assessing patients in the intensive care unit, with cardiac output measurement being crucial for hemodynamic monitoring. This is achieved by measuring the velocity‐time integral (VTI) of the left ventricular outflow tract (LVOT), which serves as a surrogate of stroke volume. However, conducting TTE in the critical care setting presents several challenges. Our primary objective was to investigate the relationship between carotid corrected flow time (cCFT) and LVOT VTI. Additionally, we aimed to determine the threshold cCFT value that reliably predicts a normal LVOT VTI.Materials and MethodsThis proof‐of‐concept study involves a post‐hoc analysis from a diagnostic accuracy investigation conducted in a medical‐surgical intensive care unit. We included patients admitted to the ICU from December 2021 to January 2022. We used a phased array transducer to measure the cCFT at the left supraclavicular fossa and the LVOT VTI in an apical 5‐chamber view.ResultsWe included 22 patients. The Spearman coefficient between LVOT VTI and cCFT was 0.82 (p < 0.0001). The area under the ROC curve for cCFT to predict LVOT VTI equal to or greater than 17 cm was 0.871 (95% CI 0.660–0.974). A cCFT exceeding 283 ms predicted LVOT VTI equal to or greater than 17 cm with a sensitivity of 93.3% (95% CI 68.1% to 99.8%) and specificity of 85.7% (95% CI 42.1% to 99.6%).ConclusionThe cCFT, measured using a novel technique with a phased array transducer, shows a strong correlation with LVOT VTI. Additionally, cCFT predicts a normal LVOT VTI with good sensitivity and specificity in critically ill patients. Larger studies are warranted to validate these findings.
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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
248
审稿时长
6 months
期刊介绍: The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.
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