Assessing Acute Ventricular Volume Changes by Intracardiac Impedance in a Chronic Heart Failure Animal Model

Autor:	Michael Lippert, Andreas Straub, Stefan Paule, Carsten Stahl, Oliver Schweika, Gerald Czygan, Tim O. Greiner, Karolin Knubben, Klaus Kettering, Volker Kühlkamp, Tobias Walker
Rok vydání:	2009
Předmět:	Cardiac function curve medicine.medical_specialty Swine medicine.medical_treatment Cardiac resynchronization therapy Hemodynamics Sensitivity and Specificity Intracardiac injection Ventricular Dysfunction Left Internal medicine medicine Animals Humans Plethysmography Impedance Heart Failure business.industry Reproducibility of Results Stroke Volume General Medicine Stroke volume medicine.disease Disease Models Animal Heart failure Acute Disease Chronic Disease Cardiology Feasibility Studies Swine Miniature End-diastolic volume Dobutamine Cardiology and Cardiovascular Medicine business medicine.drug
Zdroj:	Pacing and Clinical Electrophysiology. 32:1395-1401
ISSN:	1540-8159 0147-8389
Popis:	Background: Implantable device diagnostics may play an essential role in simplifying the care of heart failure patients by providing fundamental insights into their complex clinical patterns. Early recognition of heart failure progression by a continuous hemodynamic monitoring would allow for timely therapeutic interventions to prevent decompensation and hospitalization. In this study, the feasibility of assessing ventricular volume changes by implant-based measurements of intracardiac impedance was tested in a heart failure animal model. Methods: Heart failure was induced in five minipigs by high-rate pacing over 3 weeks. During a final open-chest examination a graded dobutamine stress test was performed. Stroke volume (SV) was measured by an ultrasonic flow probe at the ascending aorta. End diastolic pressure (EDP) and maximum pressure slope (dP/dtmax) were calculated from a left ventricular microtip catheter signal. Impedance was measured by an implanted pacemaker between biventricular leads. Stroke impedance (SZ) was calculated as the difference between end-systolic and end-diastolic impedance (EDZ). Results: Administration of dobutamine led to an increase in SV (55 ± 16%), dP/dtmax (107 ± 89%), and SZ (56 ± 30%). EDP changed by 37 ± 21% whereas EDZ changed by 7.4 ± 4%. Significant correlations were found between SZ and SV (r = 0.88), and between EDZ and EDP (r =−0.82). Conclusion: The strong correlation with SV allows the application of intracardiac impedance measurements for an implant-based continuous monitoring of cardiac function. Impedance may also be used for hemodynamic optimization of cardiac resynchronization therapy.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::97f10bb5824fca92314d4e55767d9552 https://doi.org/10.1111/j.1540-8159.2009.02477.x Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.