Non-invasive cardiovascular profiling using combined electrocardiogram-Doppler ultrasonography and impedance cardiography: An experimental approach

Summary In the present study, the feasibility of cardiovascular profiling using both combined electrocardiogram (ECG)–Doppler ultrasonography and impedance cardiography (ICG) was evaluated. Fourteen non‐pregnant healthy women received 500 mL saline solution (NaCl 0.9% at 999 mL/h) intravenously by steady state infusion. Before and after this acute volume loading, we measured orthostatic‐challenged cardiac and arterial characteristics using ICG and assessed venous characteristics by combined ECG–Doppler before and during the Valsalva manoeuvre. Changes are expressed as the mean ± SEM and were evaluated by the one‐sample Wilcoxon signed‐rank test. After volume loading, the observed fall in stroke volume after postural change from supine to standing decreased (–14 ± 3 vs –23 ± 2%; P = 0.011). Hepatic A wave velocity increased 63 ± 28% after volume loading (P = 0.007) and decreased during the Valsalva manoeuvre (–205 ± 21%; P = 0.001). Volume loading raised the thoracic fluid content index in both the supine and standing positions (7 ± 2% and 10 ± 1%, respectively; P ≤ 0.014). Combined ECG–Doppler ultrasonography and ICG enables the non‐invasive identification of concomitant haemodynamic changes at the level of the heart, the arterial bed and the venous compartment. Our data support the view that non‐invasive cardiovascular profiling is feasible, which seems particularly useful for the evaluation of patients who are not critically ill, such as pregnant women.