Key result
Miniaturized 3D accelerometers accurately track ventricular contractility, correlating strongly with invasive pressure derivatives.
Why the study?
The clinical utility of miniaturized 3D accelerometers for continuous monitoring of left and right ventricular function in a postoperative closed-chest setting was not established.
Does continuous monitoring with miniaturized 3D accelerometers accurately reflect global and regional cardiac function in a closed-chest pig model?
Does continuous monitoring with miniaturized 3D accelerometers accurately reflect global and regional cardiac function in a closed-chest pig model?
Effect estimate: r = 0.86 and r = 0.72 (pressure derivative); r = 0.82 and r = 0.73 (cardiac index)
p-value: p=<0.001
Miniaturized 3D accelerometers can accurately assess global cardiac function in a closed-chest model, suggesting potential utility for continuous postoperative monitoring after cardiac surgery.
Supports feasibility of postoperative biventricular accelerometer monitoring; leaves open effects on management or outcomes.
OBJECTIVES: Cardiac wall motions reflect systolic and diastolic function. We have previously demonstrated the ability of a miniaturized three-axis (3D) accelerometer to monitor left ventricular function in experimental models and in patients. The main aim of this study was to investigate the clinical utility of the method for monitoring the left and right ventricular function during changes in global and regional cardiac function in a postoperative closed-chest situation. METHODS: In 13 closed-chest pigs, miniaturized 3D accelerometers were placed on the left ventricle in the apical and basal regions and in the basal region of the right ventricle. An epicardial 3D motion vector was calculated from the acceleration signals in each heart region. Peak systolic velocity along this 3D vector (3D V(sys)) was compared with the positive time derivative of the left and right ventricular pressure and with cardiac index during changes in global LV function (unloading, fluid loading, esmolol, dobutamine) and with ultrasound during regional left ventricular dysfunction (3-min occlusion of the left anterior descending coronary artery). RESULTS: Significant and typical changes in accelerometer 3D V(sys) were seen in all heart regions during changes in global cardiac function. 3D V(sys) reflected the left and right ventricular contractility via significant correlations with the positive time derivative of the left and right ventricular pressure, r = 0.86 and r = 0.72, and with cardiac index r = 0.82 and r = 0.73 (all P < 0.001), respectively. The miniaturized accelerometers also detected regional dysfunction, but showed reduced ability to localize ischaemia as the 3D V(sys) in all heart regions showed similar reductions during coronary artery occlusion. CONCLUSIONS: Miniaturized 3D accelerometers placed on the heart can assess global and regional function in a closed-chest model. The technique may be used for continuous postoperative monitoring after cardiac surgery.
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Grymyr et al. (2015) studied Cardiac function monitoring (n=13). Miniaturized 3-axis (3D) accelerometers vs. Positive time derivative of ventricular pressure, cardiac index, and ultrasound was evaluated on Correlation of peak systolic velocity (3D V(sys)) with positive time derivative of left and right ventricular pressure and cardiac index (r = 0.86 and r = 0.72 (pressure derivative); r = 0.82 and r = 0.73 (cardiac index), p=<0.001). Miniaturized 3D accelerometers accurately assessed global ventricular contractility in a closed-chest pig model, correlating significantly with ventricular pressure derivatives (r=0.86, P<0.001).
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