Venous Pulse Wave Velocity variation in response to a simulated fluid challenge in healthy subjects

Ermini, Leonardo; Chiarello, Nadia Elvira; Benedictis, Carlo De; Ferraresi, Carlo; Roatta, Silvestro

doi:10.1016/j.bspc.2020.102177

Cited by 13 publications

(19 citation statements)

References 42 publications

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“…It was thus possible to measure vPWV with reasonable reliability and to confirm linear correlation between vPWV and venous pressure [2]. vPWV also exhibited good sensitivity to simulated changes in blood volume, associated with minor changes in venous pressure as observed in healthy subjects in response to passive leg raising (PLR) [3]. These results were also achieved thanks to the development of an automatic method for calculating vPWV by analysing the Doppler shift signal, as acquired by the echograph machine [2].…”

Section: Introductionmentioning

confidence: 88%

“…Respiratory movements and ECG were also collected and all transducers and devices were connected to the prototype as described above. In addition, all signals were also continuously sampled by an external acquisition board (Micro 1401 IImk, CED, Cambridge, UK, with Spike2 software) and off-line processed in Matlab ® , according to the original methodology [3]. After the initialisation phase, 10 vPWV values were collected, while the subject remained at rest in supine position (baseline); then, the PLR was performed by an operator manually raising the subject's leg at about 45 degrees.…”

Section: Methodsmentioning

confidence: 99%

“…Nowadays, the estimation of volaemic status (or volaemia) of a patient through a noninvasive method is not trivial but its development could be of great utility, given that interest in the patient's volaemic spans across several different hospital departments [1]. An innovative method for assessing the volaemic status of patients has recently been proposed: pulse wave velocity in veins, termed venous pulse wave velocity (vPWV) [2,3]. The relation among vPWV, venous pressure, and changes in blood volume was first observed in the 1970s [4,5], but the methodology was subsequently abandoned, possibly due to the difficulty of achieving reliable measurements.…”

Section: Introductionmentioning

confidence: 99%

“…In some subjects, backward pulsatility related to right atrium contractions can be observed; in others flow, is almost constant. Sending an exogenous compression synchronised with cardiac and respiratory activity allows for the measurement to be applicable and repeatable over a large pool of subjects, regardless of whether they have inherent pulsatility [2,3]. It was thus possible to measure vPWV with reasonable reliability and to confirm linear correlation between vPWV and venous pressure [2].…”

Section: Introductionmentioning

confidence: 99%

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A Portable Device for the Measurement of Venous Pulse Wave Velocity

et al. 2022

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Pulse wave velocity in veins (vPWV) has recently been reconsidered as a potential index of vascular filling, which may be valuable in the clinic for fluid therapy. The measurement requires that an exogenous pressure pulse is generated in the venous blood stream by external pneumatic compression. To obtain optimal measure repeatability, the compression is delivered synchronously with the heart and respiratory activity. We present a portable prototype for the assessment of vPWV based on the PC board Raspberry Pi and equipped with an A/D board. It acquires respiratory and ECG signals, and the Doppler shift from the ultrasound monitoring of blood velocity from the relevant vein, drives the pneumatic cuff inflation, and returns multiple measurements of vPWV. The device was tested on four healthy volunteers (2 males, 2 females, age 33±13 years), subjected to the passive leg raising (PLR) manoeuvre simulating a transient increase in blood volume. Measurement of vPWV in the basilic vein exhibited a low coefficient of variation (3.6±1.1%), a significant increase during PLR in all subjects, which is consistent with previous findings. This device allows for carrying out investigations in hospital wards on different patient populations as necessary to assess the actual clinical potential of vPWV.

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Section: Introductionmentioning

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Portable Device for the Measurement of Venous Pulse Wave Velocity

et al. 2022

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“…Edge tracking algorithms can be applied to peripheral veins to investigate, by ultrasound, the mechanical response to changes in transmural pressure, e.g., by venous occlusion, for the assessment of venous compliance (47,48) and characterize the filling condition and the expanding capacity of the peripheral reservoir, a major pathway for venous return. Assessment of venous compliance could also be used to validate another recently proposed index of peripheral vascular filling, the venous pulse wave velocity (49,50). Combining these methods with the IVC assessment might increase the understanding of the underlying mechanisms of fluid distribution and displacements across different body regions and compartments in various clinical contexts (28,29).…”

Section: Current and Future Applicationsmentioning

confidence: 99%

Assessment of Phasic Changes of Vascular Size by Automated Edge Tracking-State of the Art and Clinical Perspectives

Mesin

Albani

Policastro

et al. 2022

Front. Cardiovasc. Med.

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Assessment of vascular size and of its phasic changes by ultrasound is important for the management of many clinical conditions. For example, a dilated and stiff inferior vena cava reflects increased intravascular volume and identifies patients with heart failure at greater risk of an early death. However, lack of standardization and sub-optimal intra- and inter- operator reproducibility limit the use of these techniques. To overcome these limitations, we developed two image-processing algorithms that quantify phasic vascular deformation by tracking wall movements, either in long or in short axis. Prospective studies will verify the clinical applicability and utility of these methods in different settings, vessels and medical conditions.

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The Cardiac Caval Index: Improving Noninvasive Assessment of Cardiac Preload

Ermini

Seddone

Policastro

et al. 2021

J of Ultrasound Medicine

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Objectives-Inferior vena cava (IVC) pulsatility quantified by the Caval Index (CI) is characterized by poor reliability, also due to the irregular magnitude of spontaneous respiratory activity generating the major pulsatile component. The aim of this study was to test whether the IVC cardiac oscillatory component could provide a more stable index (Cardiac CI-CCI) compared to CI or respiratory CI (RCI).Methods-Nine healthy volunteers underwent long-term monitoring in supine position of IVC, followed by 3 minutes passive leg raising (PLR). CI, RCI, and CCI were extracted from video recordings by automated edge-tracking and CCI was averaged over each respiratory cycle (aCCI). Cardiac output (CO), mean arterial pressure (MAP) and heart rate (HR) were also recorded during baseline (1 minutes prior to PLR) and PLR (first minute).Results-In response to PLR, all IVC indices decreased (P < .01), CO increased by 4 AE 4% (P = .055) while HR and MAP did not vary. The Coefficient of Variation (CoV) of aCCI (13 AE 5%) was lower than that of CI (17 AE 5%, P < .01), RCI (26 AE 7%, P < .001) and CCI (25 AE 7%, P < .001). The mutual correlations in time of the indices were 0.81 (CI-RCI), 0.49 (CI-aCCI) and 0.2 (RCI-aCCI).Conclusions-Long-term IVC monitoring by automated edge-tracking allowed us to evidence that 1) respiratory and averaged cardiac pulsatility components are uncorrelated and thus carry different information and 2) the new index aCCI, exhibiting the lowest CoV while maintaining good sensitivity to blood volume changes, may overcome the poor reliability of CI and RCI.

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Venous Pulse Wave Velocity variation in response to a simulated fluid challenge in healthy subjects

Cited by 13 publications

References 42 publications

A Portable Device for the Measurement of Venous Pulse Wave Velocity

A Portable Device for the Measurement of Venous Pulse Wave Velocity

Assessment of Phasic Changes of Vascular Size by Automated Edge Tracking-State of the Art and Clinical Perspectives

The Cardiac Caval Index: Improving Noninvasive Assessment of Cardiac Preload

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