Cargando…

Comparison of multiple non‐invasive methods of measuring cardiac output during pregnancy reveals marked heterogeneity in the magnitude of cardiac output change between women

Various non‐invasive methods are available to measure cardiac output (CO) during pregnancy. We compared serial measures of CO using various methods to determine which provided the least variability. Ten patients with spontaneous pregnancy had estimation of CO at baseline prior to becoming pregnant a...

Descripción completa

Detalles Bibliográficos
Autores principales: Petersen, John W., Liu, Jing, Chi, Yueh‐Yun, Lingis, Melissa, Williams, R. Stan, Rhoton‐Vlasak, Alice, Segal, Mark S., Conrad, Kirk P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408281/
https://www.ncbi.nlm.nih.gov/pubmed/28438984
http://dx.doi.org/10.14814/phy2.13223
_version_ 1783232278193766400
author Petersen, John W.
Liu, Jing
Chi, Yueh‐Yun
Lingis, Melissa
Williams, R. Stan
Rhoton‐Vlasak, Alice
Segal, Mark S.
Conrad, Kirk P.
author_facet Petersen, John W.
Liu, Jing
Chi, Yueh‐Yun
Lingis, Melissa
Williams, R. Stan
Rhoton‐Vlasak, Alice
Segal, Mark S.
Conrad, Kirk P.
author_sort Petersen, John W.
collection PubMed
description Various non‐invasive methods are available to measure cardiac output (CO) during pregnancy. We compared serial measures of CO using various methods to determine which provided the least variability. Ten patients with spontaneous pregnancy had estimation of CO at baseline prior to becoming pregnant and at the end of the first and third trimesters. Echocardiographic data were used to estimate CO using the Teichholz method, Simpson's biplane method, and the Doppler determined velocity time integral (VTI) method. In addition, a Bioz Dx device was used to estimate CO by impedance cardiography. CO estimated with the VTI method had the lowest beat‐to‐beat variability. CO estimated with the VTI method was higher than CO estimated with the 2D‐Teichholz method and Simpson's method. The percent change in CO during pregnancy was similar for all echo methods (VTI, Teichholz, and Simpson's biplane). Baseline CO determined with impedance cardiography was higher than CO determined with the VTI method. However, change in CO during pregnancy was significantly lower when measured with impedance cardiography. There was marked heterogeneity in the degree of rise in CO during the first trimester (−3 to 55%). The wide variation in the gestational rise in CO was unexpected, and at least in part secondary to variable increase in heart rate. We recommend the use of the Doppler determined VTI method for the estimation of CO in pregnancy.
format Online
Article
Text
id pubmed-5408281
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-54082812017-05-02 Comparison of multiple non‐invasive methods of measuring cardiac output during pregnancy reveals marked heterogeneity in the magnitude of cardiac output change between women Petersen, John W. Liu, Jing Chi, Yueh‐Yun Lingis, Melissa Williams, R. Stan Rhoton‐Vlasak, Alice Segal, Mark S. Conrad, Kirk P. Physiol Rep Original Research Various non‐invasive methods are available to measure cardiac output (CO) during pregnancy. We compared serial measures of CO using various methods to determine which provided the least variability. Ten patients with spontaneous pregnancy had estimation of CO at baseline prior to becoming pregnant and at the end of the first and third trimesters. Echocardiographic data were used to estimate CO using the Teichholz method, Simpson's biplane method, and the Doppler determined velocity time integral (VTI) method. In addition, a Bioz Dx device was used to estimate CO by impedance cardiography. CO estimated with the VTI method had the lowest beat‐to‐beat variability. CO estimated with the VTI method was higher than CO estimated with the 2D‐Teichholz method and Simpson's method. The percent change in CO during pregnancy was similar for all echo methods (VTI, Teichholz, and Simpson's biplane). Baseline CO determined with impedance cardiography was higher than CO determined with the VTI method. However, change in CO during pregnancy was significantly lower when measured with impedance cardiography. There was marked heterogeneity in the degree of rise in CO during the first trimester (−3 to 55%). The wide variation in the gestational rise in CO was unexpected, and at least in part secondary to variable increase in heart rate. We recommend the use of the Doppler determined VTI method for the estimation of CO in pregnancy. John Wiley and Sons Inc. 2017-04-24 /pmc/articles/PMC5408281/ /pubmed/28438984 http://dx.doi.org/10.14814/phy2.13223 Text en © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Petersen, John W.
Liu, Jing
Chi, Yueh‐Yun
Lingis, Melissa
Williams, R. Stan
Rhoton‐Vlasak, Alice
Segal, Mark S.
Conrad, Kirk P.
Comparison of multiple non‐invasive methods of measuring cardiac output during pregnancy reveals marked heterogeneity in the magnitude of cardiac output change between women
title Comparison of multiple non‐invasive methods of measuring cardiac output during pregnancy reveals marked heterogeneity in the magnitude of cardiac output change between women
title_full Comparison of multiple non‐invasive methods of measuring cardiac output during pregnancy reveals marked heterogeneity in the magnitude of cardiac output change between women
title_fullStr Comparison of multiple non‐invasive methods of measuring cardiac output during pregnancy reveals marked heterogeneity in the magnitude of cardiac output change between women
title_full_unstemmed Comparison of multiple non‐invasive methods of measuring cardiac output during pregnancy reveals marked heterogeneity in the magnitude of cardiac output change between women
title_short Comparison of multiple non‐invasive methods of measuring cardiac output during pregnancy reveals marked heterogeneity in the magnitude of cardiac output change between women
title_sort comparison of multiple non‐invasive methods of measuring cardiac output during pregnancy reveals marked heterogeneity in the magnitude of cardiac output change between women
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408281/
https://www.ncbi.nlm.nih.gov/pubmed/28438984
http://dx.doi.org/10.14814/phy2.13223
work_keys_str_mv AT petersenjohnw comparisonofmultiplenoninvasivemethodsofmeasuringcardiacoutputduringpregnancyrevealsmarkedheterogeneityinthemagnitudeofcardiacoutputchangebetweenwomen
AT liujing comparisonofmultiplenoninvasivemethodsofmeasuringcardiacoutputduringpregnancyrevealsmarkedheterogeneityinthemagnitudeofcardiacoutputchangebetweenwomen
AT chiyuehyun comparisonofmultiplenoninvasivemethodsofmeasuringcardiacoutputduringpregnancyrevealsmarkedheterogeneityinthemagnitudeofcardiacoutputchangebetweenwomen
AT lingismelissa comparisonofmultiplenoninvasivemethodsofmeasuringcardiacoutputduringpregnancyrevealsmarkedheterogeneityinthemagnitudeofcardiacoutputchangebetweenwomen
AT williamsrstan comparisonofmultiplenoninvasivemethodsofmeasuringcardiacoutputduringpregnancyrevealsmarkedheterogeneityinthemagnitudeofcardiacoutputchangebetweenwomen
AT rhotonvlasakalice comparisonofmultiplenoninvasivemethodsofmeasuringcardiacoutputduringpregnancyrevealsmarkedheterogeneityinthemagnitudeofcardiacoutputchangebetweenwomen
AT segalmarks comparisonofmultiplenoninvasivemethodsofmeasuringcardiacoutputduringpregnancyrevealsmarkedheterogeneityinthemagnitudeofcardiacoutputchangebetweenwomen
AT conradkirkp comparisonofmultiplenoninvasivemethodsofmeasuringcardiacoutputduringpregnancyrevealsmarkedheterogeneityinthemagnitudeofcardiacoutputchangebetweenwomen