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New non‐invasive approach to detect cardiac contractility using the first sound of phonocardiogram

机译:使用Phonicardogram的第一个声音检测心脏收缩性的新的非侵入性方法

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Aim During surgery, a non‐invasive and easy‐to‐use method is required for evaluating left ventricular status. The systolic time interval, including pre‐ejection period (PEP), of left ventricle has been known to be correlated with cardiac contractility. In this study, we focused on the non‐invasive time interval from the Q wave of an electrocardiogram to the third component in the first heart sound (QS_(1)‐3rd) and evaluated the correlation between PEP and peak differentiated left ventricular pressure (LV dp/dt). Methods Six adult anesthetized pigs were intubated. Mechanical ventilation was started. An electrocardiogram, carotid artery blood pressure, left ventricular pressure, and phonocardiogram on the fourth left intercostal space were monitored using a polygraph system. Cardiac output was measured by the thermodilution method. Data were simultaneously measured at baseline and after the infusion of noradrenaline, nitroprusside, esmolol sulfate, and dobutamine, respectively. Data were analyzed by Spearman’s rank correlation coefficient using four‐quadrant plot analysis. Results A total of 270 points were simultaneously measured. The QS_(1)‐3rd showed a significant correlation with PEP (QS_(1)‐3rd?=?7.62?+?0.92 PEP; ρ?=?0.91,P ?
机译:在手术过程中,评估左心室状态需要非侵入性和易于使用的方法。已知左心室的收缩时间间隔包括左心室的预喷射期(PEP),与心脏收缩性相关。在这项研究中,我们专注于从心电图的Q波到第一个心声中的第三组分的非侵入式时间间隔(QS_(1)-3RD)并评估PEP和峰值之间的相关性分化左心室压力( LV DP / DT)。方法提交六种成人麻醉猪。开始机械通风。使用测谎系统监测心电图,颈动脉血压,左心室压力,左心室压力和第四个左跨越空间上的音盲。通过热稀释方法测量心输出。数据分别在基线上同时测量数据,分别在输注去甲肾上腺素,硝普钠,ESMOLOL硫酸盐和非番糖胺之后。通过使用四象限绘图分析,通过Spearman的秩相关系数分析数据。结果共测量总共270点。 QS_(1)-3RD与PEP(QS_(1)-3RD?=?7.62?+ 0.92 PEP;ρα= 0.91, P?<0.0001)。 PEP和QS_(1)-3(1)-3(排除区内)之间的一致性率为92%,(在±5?5中设定)。 PEP和QS_(1)-3RD都显示出与LV DP / DT的良好相关性(LV DP / DT?=?3861.3-24.4 PEP;ρ?= 0.85, P?0.0001,LV DP / DT ?=?3763.6-23.5 qs_(1)-3rd;ρ?= 0.82, P?<0.0001)。结论这种非侵入性和易于使用的血液动力学参数(QS_(1)-3RD)可能有助于连续监测左心收缩性能。已知左心室的收缩时间间隔包括左心室的预喷射期(PEP),与心脏收缩性相关。在这项研究中,我们专注于从心电图的Q波到第一心声的第三组分的非侵入式时间间隔(QS_(1)-3RD)并评估PEP和峰值之间分化的左心室压力之间的相关性( LV DP / DT)。这种非侵入性和易于使用的血液动力学参数(QS_(1)-3RD)可能有助于围手术期患者的管理,特别是当超声心动图没有立即可用时。

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