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Cardiac power integral: a new method for monitoring cardiovascular performance

Rimehaug, Audun Eskeland; Lyng, Oddveig; Nordhaug, Dag Ole; Løvstakken, Lasse; Aadahl, Petter; Kirkeby-Garstad, Idar
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/299777
Date
2013
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Original version
Physiological Reports 2013, 1(6):e00159   10.1002/phy2.159
Abstract
Cardiac power (PWR) is the continuous product of flow and pressure in the

proximal aorta. Our aim was to validate the PWR integral as a marker of left

ventricular energy transfer to the aorta, by comparing it to stroke work (SW)

under multiple different loading and contractility conditions in subjects without

obstructions in the left ventricular outflow tract. Six pigs were under general

anesthesia equipped with transit time flow probes on their proximal

aortas and Millar micromanometer catheters in their descending aortas to

measure PWR, and Leycom conductance catheters in their left ventricles to

measure SW. The PWR integral was calculated as the time integral of PWR

per cardiac cycle. SW was calculated as the area encompassed by the pressure–

volume loop (PV loop). The relationship between the PWR integral and SW

was tested during extensive mechanical and pharmacological interventions that

affected the loading conditions and myocardial contractility. The PWR integral

displayed a strong correlation with SW in all pigs (R2 > 0.95, P < 0.05)

under all conditions, using a linear model. Regression analysis and Bland Altman

plots also demonstrated a stable relationship. A mixed linear analysis

indicated that the slope of the SW-to-PWR-integral relationship was similar

among all six animals, whereas loading and contractility conditions tended to

affect the slope. The PWR integral followed SW and appeared to be a promising

parameter for monitoring the energy transferred from the left ventricle to

the aorta. This conclusion motivates further studies to determine whether the

PWR integral can be evaluated using less invasive methods, such as echocardiography

combined with a radial artery catheter.
Publisher
Wiley Open Access
Journal
Physiological Reports

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