Validation of impedance cardiography in pulmonary arterial hypertension

Marios Panagiotou, Ioannis Vogiatzis, Geeshath Jayasekera, Zafeiris Louvaris, Alison MacKenzie, Neil Mcglinchey, Julien Baker, Alistair Church, Andrew Peacock, Martin K. Johnson

Research output: Contribution to journalArticle

68 Downloads (Pure)

Abstract

Background Non-invasive methods of measuring cardiac output are highly desirable in pulmonary arterial hypertension (PAH). We therefore sought to validate impedance cardiography (ICG) against thermodilution (TD) and cardiac magnetic resonance (CMR) in the measurement of cardiac output in patients under investigation for PAH. Methods A prospective, cross-sectional study was performed to compare single-point measurements of cardiac output obtained by impedance cardiography (COICG) technology (PhysioFlow®) with (i) contemporaneous TD measurements (COTD) at rest and steady-state exercise during right heart catheterization and (ii) CMR measurements (COCMR) at rest obtained within 72 h. Results Paired COICG and COTD measurements were obtained in 25 subjects at rest and 16 subjects at exercise. COCMR measurements were obtained in 16 subjects at rest. There was unsatisfactory correlation and agreement between COICG and COTD at rest (r = 0·42, P = 0·035; bias: 1·21 l min−1, 95% CI: −2·33 to 4·75 l min−1) and exercise (r = .65, P = .007; bias: 1·41 l min−1; 95% CI: −3·99 to 6·81 l min−1) and in the change in COICG and COTD from rest to exercise (r = 0·53, P = 0·033; bias: 0·76 l min−1, 95% CI: −3·74 to 5·26 l min−1). There was also a lack of correlation and unsatisfactory agreement between resting COICG and COCMR (r = 0·38, P = 0·1; bias: 1·40 l min−1, 95% CI: −2·48 to 5·28 l min−1). In contrast, there was close correlation and agreement between resting COTD and COCMR (r = 0·87, P<0·001; bias: −0·16 l min−1, 95% CI: −1·97 to 1·65). Conclusions In a representative population of patients under investigation for PAH, ICG showed insufficient qualitative and quantitative value in the measurement of resting and exercise cardiac output when compared with TD and CMR.
Original languageEnglish
Pages (from-to)254-260
JournalClinical Physiology and Functional Imaging
Volume38
Issue number2
Early online date6 Feb 2017
DOIs
Publication statusPublished - 1 Mar 2018

Fingerprint

Impedance Cardiography
Pulmonary Hypertension
Cardiac Output
Thermodilution
Exercise
Magnetic Resonance Spectroscopy
Patient Advocacy
Cardiac Catheterization
Cross-Sectional Studies
Technology

Cite this

Panagiotou, M., Vogiatzis, I., Jayasekera, G., Louvaris, Z., MacKenzie, A., Mcglinchey, N., ... K. Johnson, M. (2018). Validation of impedance cardiography in pulmonary arterial hypertension. Clinical Physiology and Functional Imaging, 38(2), 254-260. https://doi.org/10.1111/cpf.12408
Panagiotou, Marios ; Vogiatzis, Ioannis ; Jayasekera, Geeshath ; Louvaris, Zafeiris ; MacKenzie, Alison ; Mcglinchey, Neil ; Baker, Julien ; Church, Alistair ; Peacock, Andrew ; K. Johnson, Martin. / Validation of impedance cardiography in pulmonary arterial hypertension. In: Clinical Physiology and Functional Imaging. 2018 ; Vol. 38, No. 2. pp. 254-260.
@article{7c12c13a57854d2aaa6150b9bb75f59b,
title = "Validation of impedance cardiography in pulmonary arterial hypertension",
abstract = "Background Non-invasive methods of measuring cardiac output are highly desirable in pulmonary arterial hypertension (PAH). We therefore sought to validate impedance cardiography (ICG) against thermodilution (TD) and cardiac magnetic resonance (CMR) in the measurement of cardiac output in patients under investigation for PAH. Methods A prospective, cross-sectional study was performed to compare single-point measurements of cardiac output obtained by impedance cardiography (COICG) technology (PhysioFlow{\circledR}) with (i) contemporaneous TD measurements (COTD) at rest and steady-state exercise during right heart catheterization and (ii) CMR measurements (COCMR) at rest obtained within 72 h. Results Paired COICG and COTD measurements were obtained in 25 subjects at rest and 16 subjects at exercise. COCMR measurements were obtained in 16 subjects at rest. There was unsatisfactory correlation and agreement between COICG and COTD at rest (r = 0·42, P = 0·035; bias: 1·21 l min−1, 95{\%} CI: −2·33 to 4·75 l min−1) and exercise (r = .65, P = .007; bias: 1·41 l min−1; 95{\%} CI: −3·99 to 6·81 l min−1) and in the change in COICG and COTD from rest to exercise (r = 0·53, P = 0·033; bias: 0·76 l min−1, 95{\%} CI: −3·74 to 5·26 l min−1). There was also a lack of correlation and unsatisfactory agreement between resting COICG and COCMR (r = 0·38, P = 0·1; bias: 1·40 l min−1, 95{\%} CI: −2·48 to 5·28 l min−1). In contrast, there was close correlation and agreement between resting COTD and COCMR (r = 0·87, P<0·001; bias: −0·16 l min−1, 95{\%} CI: −1·97 to 1·65). Conclusions In a representative population of patients under investigation for PAH, ICG showed insufficient qualitative and quantitative value in the measurement of resting and exercise cardiac output when compared with TD and CMR.",
author = "Marios Panagiotou and Ioannis Vogiatzis and Geeshath Jayasekera and Zafeiris Louvaris and Alison MacKenzie and Neil Mcglinchey and Julien Baker and Alistair Church and Andrew Peacock and {K. Johnson}, Martin",
year = "2018",
month = "3",
day = "1",
doi = "10.1111/cpf.12408",
language = "English",
volume = "38",
pages = "254--260",
journal = "Clinical Physiology and Functional Imaging",
issn = "1475-0961",
publisher = "Wiley",
number = "2",

}

Panagiotou, M, Vogiatzis, I, Jayasekera, G, Louvaris, Z, MacKenzie, A, Mcglinchey, N, Baker, J, Church, A, Peacock, A & K. Johnson, M 2018, 'Validation of impedance cardiography in pulmonary arterial hypertension', Clinical Physiology and Functional Imaging, vol. 38, no. 2, pp. 254-260. https://doi.org/10.1111/cpf.12408

Validation of impedance cardiography in pulmonary arterial hypertension. / Panagiotou, Marios; Vogiatzis, Ioannis; Jayasekera, Geeshath; Louvaris, Zafeiris; MacKenzie, Alison; Mcglinchey, Neil; Baker, Julien; Church, Alistair; Peacock, Andrew; K. Johnson, Martin.

In: Clinical Physiology and Functional Imaging, Vol. 38, No. 2, 01.03.2018, p. 254-260.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Validation of impedance cardiography in pulmonary arterial hypertension

AU - Panagiotou, Marios

AU - Vogiatzis, Ioannis

AU - Jayasekera, Geeshath

AU - Louvaris, Zafeiris

AU - MacKenzie, Alison

AU - Mcglinchey, Neil

AU - Baker, Julien

AU - Church, Alistair

AU - Peacock, Andrew

AU - K. Johnson, Martin

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Background Non-invasive methods of measuring cardiac output are highly desirable in pulmonary arterial hypertension (PAH). We therefore sought to validate impedance cardiography (ICG) against thermodilution (TD) and cardiac magnetic resonance (CMR) in the measurement of cardiac output in patients under investigation for PAH. Methods A prospective, cross-sectional study was performed to compare single-point measurements of cardiac output obtained by impedance cardiography (COICG) technology (PhysioFlow®) with (i) contemporaneous TD measurements (COTD) at rest and steady-state exercise during right heart catheterization and (ii) CMR measurements (COCMR) at rest obtained within 72 h. Results Paired COICG and COTD measurements were obtained in 25 subjects at rest and 16 subjects at exercise. COCMR measurements were obtained in 16 subjects at rest. There was unsatisfactory correlation and agreement between COICG and COTD at rest (r = 0·42, P = 0·035; bias: 1·21 l min−1, 95% CI: −2·33 to 4·75 l min−1) and exercise (r = .65, P = .007; bias: 1·41 l min−1; 95% CI: −3·99 to 6·81 l min−1) and in the change in COICG and COTD from rest to exercise (r = 0·53, P = 0·033; bias: 0·76 l min−1, 95% CI: −3·74 to 5·26 l min−1). There was also a lack of correlation and unsatisfactory agreement between resting COICG and COCMR (r = 0·38, P = 0·1; bias: 1·40 l min−1, 95% CI: −2·48 to 5·28 l min−1). In contrast, there was close correlation and agreement between resting COTD and COCMR (r = 0·87, P<0·001; bias: −0·16 l min−1, 95% CI: −1·97 to 1·65). Conclusions In a representative population of patients under investigation for PAH, ICG showed insufficient qualitative and quantitative value in the measurement of resting and exercise cardiac output when compared with TD and CMR.

AB - Background Non-invasive methods of measuring cardiac output are highly desirable in pulmonary arterial hypertension (PAH). We therefore sought to validate impedance cardiography (ICG) against thermodilution (TD) and cardiac magnetic resonance (CMR) in the measurement of cardiac output in patients under investigation for PAH. Methods A prospective, cross-sectional study was performed to compare single-point measurements of cardiac output obtained by impedance cardiography (COICG) technology (PhysioFlow®) with (i) contemporaneous TD measurements (COTD) at rest and steady-state exercise during right heart catheterization and (ii) CMR measurements (COCMR) at rest obtained within 72 h. Results Paired COICG and COTD measurements were obtained in 25 subjects at rest and 16 subjects at exercise. COCMR measurements were obtained in 16 subjects at rest. There was unsatisfactory correlation and agreement between COICG and COTD at rest (r = 0·42, P = 0·035; bias: 1·21 l min−1, 95% CI: −2·33 to 4·75 l min−1) and exercise (r = .65, P = .007; bias: 1·41 l min−1; 95% CI: −3·99 to 6·81 l min−1) and in the change in COICG and COTD from rest to exercise (r = 0·53, P = 0·033; bias: 0·76 l min−1, 95% CI: −3·74 to 5·26 l min−1). There was also a lack of correlation and unsatisfactory agreement between resting COICG and COCMR (r = 0·38, P = 0·1; bias: 1·40 l min−1, 95% CI: −2·48 to 5·28 l min−1). In contrast, there was close correlation and agreement between resting COTD and COCMR (r = 0·87, P<0·001; bias: −0·16 l min−1, 95% CI: −1·97 to 1·65). Conclusions In a representative population of patients under investigation for PAH, ICG showed insufficient qualitative and quantitative value in the measurement of resting and exercise cardiac output when compared with TD and CMR.

U2 - 10.1111/cpf.12408

DO - 10.1111/cpf.12408

M3 - Article

VL - 38

SP - 254

EP - 260

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

SN - 1475-0961

IS - 2

ER -

Panagiotou M, Vogiatzis I, Jayasekera G, Louvaris Z, MacKenzie A, Mcglinchey N et al. Validation of impedance cardiography in pulmonary arterial hypertension. Clinical Physiology and Functional Imaging. 2018 Mar 1;38(2):254-260. https://doi.org/10.1111/cpf.12408