Paediatrics Publications
Document Type
Article
Publication Date
1-1-2010
Journal
Experimental Physiology
Volume
95
Issue
4
First Page
561
Last Page
568
URL with Digital Object Identifier
10.1113/expphysiol.2009.050815
Abstract
We compared Modelflow (MF) estimates of cardiac stroke volume (SV) from the finger pressure-pulse waveform (Finometer®) with pulsed Doppler ultrasound (DU) of the ascending aorta during acute changes in total peripheral resistance (TPR) in the supine and head-up-tilt (HUT) postures. Twenty-four women were tested during intravenous infusion of 0.005 or 0.01 μg kg -1 min-1 isoprenaline, 10 or 50 ng kg-1 min-1 noradrenaline and 0.3 mg sublingual nitroglycerine. Responses to static hand-grip exercise (SHG), graded lower body negative pressure (LBNP, from -20 to -45 mmHg) and 45 deg HUT were evaluated on separate days. Bland-Altman analysis indicated that SVMF yielded lower estimates than SVDU during infusion of 0.01 μg kg-1 min -1 isoprenaline (SVMF 92.7 ± 15.5 versus SV DU 104.3 ± 22.9 ml, P = 0.03) and SHG (SVMF 78.8 ± 12.0 versus SVDU 106.1 ± 28.5 ml, P < 0.01), while larger estimates were recorded with SVMF during -45 mmHg LBNP (SVMF 52.6 ± 10.7 versus SVDU 46.2 ± 14.5 ml, P = 0.04) and HUT (SVMF 59.3 ± 13.6 versus SVDU 45.2 ± 11.3 ml, P < 0.01). Linear regression analysis revealed a relationship (r2 = 0.41, P < 0.01) between the change in TPR from baseline and the between-methods discrepancy in SV measurements. This relationship held up under all of the experimental protocols (regression for fixed effects, P = 0.46). These results revealed a discrepancy in MF estimates of SV, in comparison with those measured by DU, during acute changes in TPR. © 2010 The Physiological Society.