Abstract
The stroke volume of the left ventricle (SV) was calculated from noninvasive recordings of the arterial pressure using a finger photoplethysmograph and compared to the values obtained by pulsed Doppler echocardiography (PDE). A group of 19 healthy men and 12 women [mean ages: 20.8 (SD 1.6) and 22.2 (SD 1.6) years respectively] were studied at rest in the supine position. The ratio of the area below the ejection phase of the arterial pressure wave (A s) to SV, as obtained by PDE, yielded a “calibration factor” dimensionally equal to the hydraulic impedance of the system (Z ao =A s ·SV −1). TheZ ao amounted on average to 0.062 (SD 0.018) mmHg · s · cm−3 for the men and to 0.104 (SD 0.024) mmHg · s · cm−3 for the women. TheZ ao was also estimated from the equation:Z ao = a · (d + b ·HR + c ·PP + e ·MAP)−1, whereHR was the heart rate,PP the pulse pressure,MAP the mean arterial pressure and the coefficients of the equation were obtained by an iterating statistical package. The value ofZ ao thus obtained allowed the calculation of SV from measurements derived from the photoplethysmograph only. The mean percentage error between the SV thus obtained and those experimentally determined by PDE amounted to 14.8 and 15.6 for the men and the women, respectively. The error of the estimate was reduced to 12.3 and to 11.1, respectively, if the factorZ ao, experimentally obtained from a given heart beat, was subsequently applied to other beats to obtain SV from theA s measurement in the same subject.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bader H (1967) Dependence of wall in the human thoracic aorta on age and pressure. Circ Res 20:354–361
Christie J, Sheldahl LM, Tristiani FE, Sagar KB, Ptacin MJ, Sann S (1987) Determination of two-dimensional and Doppler echocardiography, Fick oxymetry and thermodilution. Circulation 76:539–547
Coats AJS (1990) Doppler ultrasonic measurement of cardiac output: reproducibility and validation. Eur Heart J 11 [Suppl 1]:49–61
Conway J (1990) Clinical assessment of cardiac output. Eur Heart J 11 [Suppl 1]:148–150
Hildebrandt W, Schutze H, Stegemann J (1991) On the reliability of the Penaz cuff during systemic and local vasodilatation at rest and during exercise. Eur J Appl Physiol 62:175–179
Imholz BPM, Montfrans GA van, Settels JJ, Hoeven GA van der, Karemaker JM, Wieling W (1988) Continuous non invasive blood pressure monitoring: reliability of Finapres device during the Valsalva manoeuvre. Cardiovasc Res 22:390–397
Imholz BPM, Settels JJ, Meiracker AH van der, Wesseling KH, Wieling W (1990) Non invasive continuous finger blood pressure measurement during orthostatic stress compared to intra-arterial pressure. Cardiovasc Res 24:214–221
Jansen JRC, Wesseling KH, Settels JJ, Schreuder JJ (1990) Continuous cardiac output monitoring by pulse contour during cardiac surgery. Eur Heart J 11 [Suppl 1]:26–32
Kurki T, Smith NT, Head N, Dec Silver H, Quinn A (1987) Non invasive continuous blood pressure from the finger: optimal measurement conditions and factors affecting reliability. J Clin Monit 3:6–13
Langewouters GJ, Wesseling KH, Goedhard VJA (1985) The pressure dependent dynamic elasticity of 35 thoracic and 16 abdominal human aortas in vitro described by a five component model. J Biomech 18:613–620
Levick JR (1991) An introduction to cardiovascular physiology. Butterworth, London, pp 102–104
Loeppky JA, Greene ER, Hoekenga DE, Caprihan A, Luft UC (1981) Beat-by-beat stroke volume assessment by pulsed Doppler in upright and supine exercise. J Appl Physiol 50:1173–1182
Nichols WW (1973) Continuous cardiac output derived from the aortic pressure waveform: a review of current methods. Biomed Eng 8:376–379
Parati G, Casadei R, Groppelli A, Di Rienzo M, Mancia G (1989) Comparison of finger and intra-arterial blood pressure monitoring at rest and during laboratory testing. Hypertension 13:647–655
Penaz J (1973) Photoelectric measurements of blood pressure, volume and flow in the finger. Digest of 10th International Conference of Medical Biological Engineering, Dresden, p 104
Sprangers RLH (1990) Determination of stroke volume by the pulse contour method. On the role of cardiopulmonary receptors at the onset of muscular exercise. Thesis, University of Amsterdam, Rhodopi, Amsterdam, pp 35–54
Stok WJ, Baisch F, Hillerbrecht A, Schulz H, Meyer M, Karemaker JM (1993) Non-invasive cardiac output measurement by arterial pulse analysis compared to inert gas re-breathing. J Appl Physiol 74:2687–2693
Swan HJC, Ganz W, Forrester MH jr, Diamond G, Chonette D (1970) Catheterization of the heart in man with use of a flow directed balloon-tipped catheter. N Engl J Med 283:447–451
Wesseling KH, Smith NT, Nichols WW, Weber H, Wit B de, Beneken JEW (1974) Beat to beat cardiac output from the arterial pressure pulse contour. In: Feldman SA, Leigh JM, Spierdijk J (eds) Measurement anaesthesia. University Press, Leiden, pp 150–164
Wesseling KH, Wit B de, Settels JJ, Klawer WH (1982) On the indirect registration of finger blood pressure after Penaz. Funkt Biol Med 1:245–250
Wesseling KH, Wit B de, Weber JAP, Smith NT (1983) A simple device for the continuous measurement of cardiac output. Adv Cardiovasc Phys 5 [Suppl II]:16–52
Wesseling KH, Settels JJ, Hoeven GA van der, Nijboer JA, Butijn MWT, Dorlas JC (1985) Effects of peripheral vasoconstriction on the measurements of blood pressure in a finger. Cardiovasc Res 19:139–145
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Antonutto, G., Girardis, M., Tuniz, D. et al. Assessment of cardiac output from noninvasive determination of arterial pressure profile in subjects at rest. Europ. J. Appl. Physiol. 69, 183–188 (1994). https://doi.org/10.1007/BF01094786
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01094786