Evaluation of stroke volume estimation during orthostatic stress: the utility of Modelflow.
Journal
Blood pressure monitoring
ISSN: 1473-5725
Titre abrégé: Blood Press Monit
Pays: England
ID NLM: 9606438
Informations de publication
Date de publication:
01 Dec 2023
01 Dec 2023
Historique:
medline:
2
11
2023
pubmed:
4
9
2023
entrez:
4
9
2023
Statut:
ppublish
Résumé
Advanced blood pressure monitoring devices contain algorithms that permit estimation of stroke volume (SV). Modelflow (Finapres Medical Systems) is one common method to non-invasively estimate beat-to-beat SV. However, Modelflow accuracy during profound reductions in SV is unclear. We aimed to compare SV estimation by Modelflow and echocardiography, at rest and during orthostatic challenge. We tested 13 individuals (age 24 ± 2 years; 7 female) using combined head-up tilt and graded lower body negative pressure, continued until presyncope. SV was derived by both Modelflow and echocardiography on multiple occasions while supine, during orthostatic stress, and at presyncope. SV index (SVI) was determined by normalising SV for body surface area. Bias and limits of agreement were determined using Bland-Altman analyses. Two one-sided tests (TOST) examined equivalency. Across all timepoints, Modelflow estimates of SV (73.2 ± 1.6 ml) were strongly correlated with echocardiography estimates (66.1 ± 1.3 ml) (r = 0.56, P < 0.001) with a bias of +7.1 ± 21.1 ml. Bias across all timepoints was further improved when SV was indexed (+3.6 ± 12.0 ml.m -2 ). Likewise, when assessing responses relative to baseline, Modelflow estimates of SV (-23.4 ± 1.4%) were strongly correlated with echocardiography estimates (-19.2 ± 1.3%) (r = 0.76, P < 0.001), with minimal bias (-4.2 ± 13.1%). TOST testing revealed equivalency to within 15% of the clinical standard for SV and SVI, both expressed as absolute values and relative to baseline. Modelflow can be used to track changes in SV during profound orthostatic stress, with accuracy enhanced with correction relative to baseline values or body size. These data support the use of Modelflow estimates of SV for autonomic function testing.
Identifiants
pubmed: 37661717
doi: 10.1097/MBP.0000000000000671
pii: 00126097-990000000-00075
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
330-337Subventions
Organisme : National Sciences and Engineering Research Council
ID : Discovery RGPIN/02982-2021
Organisme : National Sciences and Engineering Research Council
ID : Discovery Accelerator Supplement RGPAS/2021-00012-2021
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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