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Comparison of cardiac output estimates obtained from the Antares oscillometric pulse wave analysis algorithm and from
Alexander Stäuber1, Matthias Wilhelm Hoppe2, Harald Lapp3
1Department of Movement and Training Science, Leipzig University, Leipzig, Germany.
Insights
The Antares oscillometric pulse wave analysis (PWA) algorithm shows high correlation with transthoracic Doppler echocardiography (TTE) for estimating cardiac output (CO) in both male and female patients. This non-invasive method offers a promising alternative for routine CO assessment.
Area of Science:
- Cardiology
- Medical Devices
- Biomedical Engineering
Background:
- Cardiac output (CO) is crucial for assessing cardiac function.
- Invasive thermodilution is the gold standard, but transthoracic Doppler echocardiography (TTE) is standard for routine clinical use.
- Non-invasive methods like oscillometric pulse wave analysis (PWA) are sought for improved accuracy and accessibility.
Purpose of the Study:
- To compare the non-invasive CO estimation accuracy of the Antares oscillometric PWA algorithm against TTE.
- To evaluate the reliability of Antares for CO assessment in a clinical setting.
Main Methods:
- 59 patients undergoing cardiac catheterization were included.
- Non-invasive CO data from TTE were compared with measurements from the Antares PWA algorithm.
- Agreement was assessed using Bland-Altman analysis, Student's t-test, and Pearson correlations.
Main Results:
- The mean difference in CO between Antares and TTE was 0.04 ± 1.03 l/min.
- No statistically significant difference was found between the two CO measurement methods (P = 0.785).
- Strong correlations were observed between Antares and TTE for CO estimation in the overall cohort (r = 0.705) and in both male (r = 0.669) and female (r = 0.802) patients.
Conclusions:
- The Antares oscillometric PWA algorithm demonstrates high correlation with TTE for non-invasive CO estimation.
- Both methods showed no statistically significant difference, suggesting Antares' potential as a viable alternative.
- Further validation studies are recommended before widespread clinical adoption of Antares for CO assessment.
Background:
In cardiology, cardiac output (CO) is an important parameter for assessing cardiac function. While invasive thermodilution procedures are the gold standard for CO assessment, transthoracic Doppler echocardiography (TTE) has become the established method for routine CO assessment in daily clinical practice. However, a demand persists for non-invasive approaches, including oscillometric pulse wave analysis (PWA), to enhance the accuracy of CO estimation, reduce complications associated with invasive procedures, and facilitate its application in non-intensive care settings. Here, we aimed to compare the TTE and oscillometric PWA algorithm Antares for a non-invasive estimation of CO.
Methods:
Non-invasive CO data obtained by two-dimensional TTE were compared with those from an oscillometric blood pressure device (custo med GmbH, Ottobrunn, Germany) using the integrated algorithm Antares (Redwave Medical GmbH, Jena, Germany). In total, 59 patients undergoing elective cardiac catheterization for clinical reasons (71±10 years old, 76% males) were included. Agreement between both CO measures were assessed by Bland-Altman analysis, Student's t-test, and Pearson correlations.
Results:
The mean difference in CO was 0.04 ± 1.03 l/min (95% confidence interval for the mean difference: -0.23 to 0.30 l/min) for the overall group, with lower and upper limits of agreement at -1.98 and 2.05 l/min, respectively. There was no statistically significant difference in means between both CO measures (P = 0.785). Statistically significant correlations between TTE and Antares CO were observed in the entire cohort (r = 0.705, P<0.001) as well as in female (r = 0.802, P<0.001) and male patients (r = 0.669, P<0.001).
Conclusions:
The oscillometric PWA algorithm Antares and established TTE for a non-invasive estimation of CO are highly correlated in male and female patients, with no statistically significant difference between both approaches. Future validation studies of the Antares CO are necessary before a clinical application can be considered.
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