scholarly journals Relationship between Stroke Volume and Pulse Pressure during Blood Volume Perturbation: A Mathematical Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Ramin Bighamian ◽  
Jin-Oh Hahn
Keyword(s):  
Stroke Volume ◽  
Blood Volume ◽  
Fluid Therapy ◽  
Pulse Pressure ◽  
Mathematical Analysis ◽  
Left Ventricular ◽  
Experimental Investigations ◽  
Arterial Pulse ◽  
Arterial Pulse Pressure ◽  
Relative Change

Arterial pulse pressure has been widely used as surrogate of stroke volume, for example, in the guidance of fluid therapy. However, recent experimental investigations suggest that arterial pulse pressure is not linearly proportional to stroke volume. However, mechanisms underlying the relation between the two have not been clearly understood. The goal of this study was to elucidate how arterial pulse pressure and stroke volume respond to a perturbation in the left ventricular blood volume based on a systematic mathematical analysis. Both our mathematical analysis and experimental data showed that the relative change in arterial pulse pressure due to a left ventricular blood volume perturbation was consistently smaller than the corresponding relative change in stroke volume, due to the nonlinear left ventricular pressure-volume relation during diastole that reduces the sensitivity of arterial pulse pressure to perturbations in the left ventricular blood volume. Therefore, arterial pulse pressure must be used with care when used as surrogate of stroke volume in guiding fluid therapy.

Evaluation of Stroke Volume via Arterial Pulse Pressure Waveforms in Neonatal Lambs

Neonatology ◽  
2004 ◽  
Vol 86 (3) ◽  
pp. 184-194 ◽  
Author(s):  
Sherri Kappler ◽  
Jay M. Milstein ◽  
Anita J. Moon-Grady ◽  
Stephen H. Bennett
Keyword(s):  
Stroke Volume ◽  
Pulse Pressure ◽  
Arterial Pulse ◽  
Arterial Pulse Pressure ◽  
Neonatal Lambs

EVALUATION OF STROKE VOLUME VIA ARTERIAL PULSE PRESSURE WAVEFORMS IN NEONATAL LAMBS.

2004 ◽  
Vol 52 ◽  
pp. S119
Author(s):  
S. Kappler ◽  
J. M. Milstein ◽  
A. J. Moon-Grady ◽  
S. H. Bennett
Keyword(s):  
Stroke Volume ◽  
Pulse Pressure ◽  
Arterial Pulse ◽  
Arterial Pulse Pressure ◽  
Neonatal Lambs

A questionable association of stroke volume and arterial pulse pressure under gravitational stress

2012 ◽  
Vol 72 (3) ◽  
pp. 708-712 ◽  
Author(s):  
Anita T. Cote ◽  
Aaron A. Phillips ◽  
Shannon S. D. Bredin ◽  
Darren E. R. Warburton
Keyword(s):  
Stroke Volume ◽  
Pulse Pressure ◽  
Arterial Pulse ◽  
Arterial Pulse Pressure ◽  
Gravitational Stress

scholarly journals Effects of Acute Pump Speed Changes on Cerebral Hemodynamics in Patients With an Implantable Continuous-Flow Left Ventricular Assist Devices

2021 ◽  
pp. 831-839
Author(s):  
M. Konarik ◽  
M. Sramko ◽  
Z. Dorazilova ◽  
M. Blaha ◽  
I. Netuka ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Pulse Pressure ◽  
Continuous Flow ◽  
Left Ventricular ◽  
Arterial Pulse ◽  
Ventricular Assist ◽  
Pump Speed ◽  
Left Ventricular Assist ◽  
Relative Change

Mechanical circulatory support (MCS) with an implantable left ventricular assist device (LVAD) is an established therapeutic option for advanced heart failure. Most of the currently used LVADs generate a continuous stream of blood that decreases arterial pulse pressure. This study investigated whether a change of the pulse pressure during different pump speed settings would affect cerebral autoregulation and thereby affect cerebral blood flow (CBF). The study included 21 haemodynamically stable outpatients with a continuous-flow LVAD (HeartMate II, Abbott, USA) implanted a median of 6 months before the study (interquartile range 3 to 14 months). Arterial blood pressure (measured by finger plethysmography) was recorded simultaneously with CBF (measured by transcranial Doppler ultrasound) during baseline pump speed (8900 rpm [IQR 8800; 9200]) and during minimum and maximum tolerated pump speeds (8000 rpm [IQR 8000; 8200] and 9800 rpm [IQR 9800; 10 000]). An increase in LVAD pump speed by 800 rpm [IQR 800; 1000] from the baseline lead to a significant decrease in arterial pulse pressure and cerebral blood flow pulsatility (relative change −24 % and −32 %, both p < 0.01), but it did not affect mean arterial pressure and mean CBF velocity (relative change 1 % and −1.7 %, p=0.1 and 0.7). In stable patients with a continuous-flow LVAD, changes of pump speed settings within a clinically used range did not impair static cerebral autoregulation and cerebral blood flow.

Effect of an acute increase in central blood volume on cerebral hemodynamics

2015 ◽  
Vol 309 (8) ◽  
pp. R902-R911 ◽  
Author(s):  
Shigehiko Ogoh ◽  
Ai Hirasawa ◽  
Peter B. Raven ◽  
Thomas Rebuffat ◽  
Pierre Denise ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Blood Volume ◽  
Pulse Pressure ◽  
Parabolic Flight ◽  
Central Blood Volume ◽  
Arterial Pulse ◽  
Vascular Conductance ◽  
Systemic Hemodynamic ◽  
Arterial Pulse Pressure ◽  
Acute Increase

Systemic blood distribution is an important factor involved in regulating cerebral blood flow (CBF). However, the effect of an acute change in central blood volume (CBV) on CBF regulation remains unclear. To address our question, we sought to examine the CBF and systemic hemodynamic responses to microgravity during parabolic flight. Twelve healthy subjects were seated upright and exposed to microgravity during parabolic flight. During the brief periods of microgravity, mean arterial pressure was decreased (−26 ± 1%, P < 0.001), despite an increase in cardiac output (+21 ± 6%, P < 0.001). During microgravity, central arterial pulse pressure and estimated carotid sinus pressure increased rapidly. In addition, this increase in central arterial pulse pressure was associated with an arterial baroreflex-mediated decrease in heart rate ( r = −0.888, P < 0.0001) and an increase in total vascular conductance ( r = 0.711, P < 0.001). The middle cerebral artery mean blood velocity (MCA Vmean) remained unchanged throughout parabolic flight ( P = 0.30). During microgravity the contribution of cardiac output to MCA Vmean was gradually reduced ( P < 0.05), and its contribution was negatively correlated with an increase in total vascular conductance ( r = −0.683, P < 0.0001). These findings suggest that the acute loading of the arterial and cardiopulmonary baroreceptors by increases in CBV during microgravity results in acute and marked systemic vasodilation. Furthermore, we conclude that this marked systemic vasodilation decreases the contribution of cardiac output to CBF. These findings suggest that the arterial and cardiopulmonary baroreflex-mediated peripheral vasodilation along with dynamic cerebral autoregulation counteracts a cerebral overperfusion, which otherwise would occur during acute increases in CBV.

Abstract 16747: The Artificial Pulse of the HeartMate3 LVAD Alters Mean Arterial Pressure Calculation, and the Relationship Between Arterial Pulse Pressure and Pulsatility Index

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Lorenzo Braghieri ◽  
Alberto Pinsino ◽  
Giulio Mondellini ◽  
Antonia Gaudig ◽  
Azka Javaid ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Pressure ◽  
Pulsatility Index ◽  
Left Ventricular ◽  
Absolute Difference ◽  
Arterial Line ◽  
Arterial Pulse ◽  
Relative Contribution ◽  
Arterial Pulse Pressure

Introduction: The HeartMate (HM3) left ventricular assist device (LVAD) uniquely features an artificial pulse (AP) (designed to reduce blood stasis and simulate physiologic pulsatility) that alters arterial blood pressure (BP) tracings ( Fig. 1A ). Pulsatility Index (PI) corresponds to the magnitude of flow pulse through the LVAD and is used as a surrogate measure of arterial pulse pressure (PP). The effect of the AP on: i) relative contribution of systolic BP (SBP) and diastolic BP (DBP) to mean arterial pressure (MAP) calculation; and ii) association between PP and PI is presently unknown. Thus, we aimed to compare: i) MAP calculations; and ii) relation of PI with PP in HM3 vs HM II (LVAD with no AP) pts with arterial line (A-line) monitoring. Methods: A-line BP and LVAD PI data were prospectively collected in 48 HM3 and 29 HMII pts. MAP was calculated with the formula conventionally used in non LVAD pts (MAP = 2/3 DBP + 1/3 SBP) and compared to A-line MAP. Among HM3 pts, a multiple linear regression model was fit with A-line SBP and DBP as predictor variables, and A-line MAP as the dependent variable to derive the HM3 MAP Formula . The relation between arterial PP and PI in HM3 and HMII pts was assessed using Pearson’s correlation. Results: MAP calculated using the conventional formula accurately estimated A-line MAP in HMII pts, but overestimated A-line MAP in HM3 pts. The HM3 MAP Formula more closely approximated A-line MAP. Mean observed difference (MOD) and mean absolute difference (MAD) between calculated MAPs and A-line MAPs are reported in Fig. 1B . While median PP was similar in HM3 and HMII pts (16 vs 20 mmHg, p=0.11), median PI was significantly higher in HMII pts (3.45 vs 5.6, p<0.001). PI correlated with PP in HMII pts ( r 0.47, p=0.01). However, no significant correlation was found between PI and PP in HM3 pts ( r 0.24, p=0.1; Fig. 1C ). Conclusions: In HM3 pts, the AP significantly alters the relative contribution of SBP and DBP to MAP. Unlike in HM2 pts, PI does not relate to arterial PP in HM3 pts.

229 EVALUATION OF STROKE VOLUME VIA ARTERIAL PULSE PRESSURE WAVEFORMS IN NEONATAL LAMBS.

2004 ◽  
Vol 52 (Suppl 1) ◽  
pp. S119.3-S119
Author(s):  
S. Kappler ◽  
J. M. Milstein ◽  
A. J. Moon-Grady ◽  
S. H. Bennett
Keyword(s):  
Stroke Volume ◽  
Pulse Pressure ◽  
Arterial Pulse ◽  
Arterial Pulse Pressure ◽  
Neonatal Lambs
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