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        A Comparison of Mathematical Models of Left Ventricular Contractility Derived from Aortic Blood Flow Velocity and Acceleration: Application to the Esophageal Doppler Monitor

        Glen Atlas,John K-J. Li,John B. Kostis 대한의용생체공학회 2014 Biomedical Engineering Letters (BMEL) Vol.4 No.3

        Purpose The esophageal Doppler monitor (EDM) hastraditionally been used for minimally-invasive and continuousassessment of both cardiac output and intravascular volume. These measurements are based upon a beat-to-beat analysisof the velocity of distal thoracic aortic blood flow. Thepurpose of this paper is to compare different mathematicalmodels of LV contractile function which could utilize theEDM and subsequently be determined on a continuous basis. Methods This study investigated velocity-based contractilitymodels: peak velocity, (PV); ejection fraction, EF; meanejection fraction, ; and maximum LV radial shorteningvelocity, . Also examined are acceleration-basedmodels: mean acceleration, (MA); force, (F); the maximumrate of rise of systolic arterial blood pressure, ; andkinetic energy, (KE). Results When normalized and subsequently observed on adimensionless basis, acceleration-based models appear tohave a statistically significant greater sensitivity to changesin LV contractility. Furthermore, by combining simultaneousarterial blood pressure measurements with EDM-based flow information, the components of afterload and their effects onLV contractility could be estimated. Conclusions Future research is warranted to determine theapplicability and limitations of the EDM in continuousassessment of LV contractility and related hemodynamicparameters.

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