Performance evaluation of a portable bioimpedance cardiac output monitor for measuring hemodynamic changes in athletes during a head-up tilt test
Cardiac output (CO) monitoring is useful for sports performance training, but most methods are unsuitable as they are invasive or hinder performance. The performance of PhysioFlow (PF), a portable noninvasive transthoracic bioimpedance CO monitor, was evaluated and compared with a reference Doppler...
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| Veröffentlicht in: | Journal of applied physiology (1985) 2020-05, Vol.128 (5), p.1146-1152 |
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| creator | Cheung, Cara H Y Khaw, May L Tam, Victor C W Ying, Michael T C Lee, Shara W Y |
| description | Cardiac output (CO) monitoring is useful for sports performance training, but most methods are unsuitable as they are invasive or hinder performance. The performance of PhysioFlow (PF), a portable noninvasive transthoracic bioimpedance CO monitor, was evaluated and compared with a reference Doppler CO monitor, USCOM, using a head-up tilt (HUT) test. With ethics committee approval, 20 healthy well-trained athletes were subjected to HUT in a fixed order of 0°, 70°, 30°, and 0° for 3 min each. Simultaneous hemodynamic measurements using PF and USCOM were made 30 s after a change in HUT and analyzed using
tests, ANOVA, and mountain plots. Heart rate (HR) and stroke volume (SV) from both monitors changed according to physiological expectation of tilt, but PF measurements of SV were higher with a positive bias (PF vs. USCOM, 0°: 87.3 vs. 54.0 mL,
< 0.001; 70°: 76.5 vs. 39.5 mL,
< 0.001; 30°: 81.4 vs. 50.1 mL,
< 0.001; 0°: 88.3 vs. 57.1 mL,
< 0.001). Relative changes in SV (∆SV) after each tilt measured using PF were lower with a negative bias (PF vs. USCOM, 0° to 70°: -12.3% vs. -26.3%,
= 0.002; 70° to 30°: +6.4% vs. +31.2%,
< 0.001; 30° to 0°: +9.2% vs. +15.8%,
= 0.280). CO measurements using PF at 70° were erroneous. Compared with USCOM, PF overestimated SV measurements but underestimated the ∆SV between HUT. Accuracy of the PF deteriorated at 70°, implying a gravitational influence on its performance. These findings suggested that the suitability of PF for sports use is questionable.
The use of impedance cardiography to monitor physiological changes in sports is rarely reported. Using head-up tilt test, we evaluated a portable noninvasive impedance cardiography device (PhysioFlow) by comparing it with a reference Doppler monitor (USCOM). Accuracy in tracking hemodynamic changes deteriorated with higher tilt, implying a gravitational influence on its performance. Stroke volume measurements were overestimated, but the changes were underestimated. Despite its convenient physical features, the suitability of PhysioFlow for sports use is questionable. |
| doi_str_mv | 10.1152/japplphysiol.00822.2019 |
| format | Article |
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tests, ANOVA, and mountain plots. Heart rate (HR) and stroke volume (SV) from both monitors changed according to physiological expectation of tilt, but PF measurements of SV were higher with a positive bias (PF vs. USCOM, 0°: 87.3 vs. 54.0 mL,
< 0.001; 70°: 76.5 vs. 39.5 mL,
< 0.001; 30°: 81.4 vs. 50.1 mL,
< 0.001; 0°: 88.3 vs. 57.1 mL,
< 0.001). Relative changes in SV (∆SV) after each tilt measured using PF were lower with a negative bias (PF vs. USCOM, 0° to 70°: -12.3% vs. -26.3%,
= 0.002; 70° to 30°: +6.4% vs. +31.2%,
< 0.001; 30° to 0°: +9.2% vs. +15.8%,
= 0.280). CO measurements using PF at 70° were erroneous. Compared with USCOM, PF overestimated SV measurements but underestimated the ∆SV between HUT. Accuracy of the PF deteriorated at 70°, implying a gravitational influence on its performance. These findings suggested that the suitability of PF for sports use is questionable.
The use of impedance cardiography to monitor physiological changes in sports is rarely reported. Using head-up tilt test, we evaluated a portable noninvasive impedance cardiography device (PhysioFlow) by comparing it with a reference Doppler monitor (USCOM). Accuracy in tracking hemodynamic changes deteriorated with higher tilt, implying a gravitational influence on its performance. Stroke volume measurements were overestimated, but the changes were underestimated. Despite its convenient physical features, the suitability of PhysioFlow for sports use is questionable.</description><identifier>ISSN: 8750-7587</identifier><identifier>EISSN: 1522-1601</identifier><identifier>DOI: 10.1152/japplphysiol.00822.2019</identifier><identifier>PMID: 32213113</identifier><language>eng</language><publisher>United States: American Physiological Society</publisher><subject>Athletes ; Bias ; Carbon monoxide ; Cardiac output ; Ethical standards ; Gravity ; Gravity effects ; Heart rate ; Hemodynamics ; Performance evaluation ; Sports ; Stroke volume ; Variance analysis</subject><ispartof>Journal of applied physiology (1985), 2020-05, Vol.128 (5), p.1146-1152</ispartof><rights>Copyright American Physiological Society May 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-6fa9d763162111f2de6bd15e039cb1fa5e4bad38a2e22c8cbc9b1d263ffea2f83</citedby><cites>FETCH-LOGICAL-c390t-6fa9d763162111f2de6bd15e039cb1fa5e4bad38a2e22c8cbc9b1d263ffea2f83</cites><orcidid>0000-0001-5257-2076</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3026,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32213113$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheung, Cara H Y</creatorcontrib><creatorcontrib>Khaw, May L</creatorcontrib><creatorcontrib>Tam, Victor C W</creatorcontrib><creatorcontrib>Ying, Michael T C</creatorcontrib><creatorcontrib>Lee, Shara W Y</creatorcontrib><title>Performance evaluation of a portable bioimpedance cardiac output monitor for measuring hemodynamic changes in athletes during a head-up tilt test</title><title>Journal of applied physiology (1985)</title><addtitle>J Appl Physiol (1985)</addtitle><description>Cardiac output (CO) monitoring is useful for sports performance training, but most methods are unsuitable as they are invasive or hinder performance. The performance of PhysioFlow (PF), a portable noninvasive transthoracic bioimpedance CO monitor, was evaluated and compared with a reference Doppler CO monitor, USCOM, using a head-up tilt (HUT) test. With ethics committee approval, 20 healthy well-trained athletes were subjected to HUT in a fixed order of 0°, 70°, 30°, and 0° for 3 min each. Simultaneous hemodynamic measurements using PF and USCOM were made 30 s after a change in HUT and analyzed using
tests, ANOVA, and mountain plots. Heart rate (HR) and stroke volume (SV) from both monitors changed according to physiological expectation of tilt, but PF measurements of SV were higher with a positive bias (PF vs. USCOM, 0°: 87.3 vs. 54.0 mL,
< 0.001; 70°: 76.5 vs. 39.5 mL,
< 0.001; 30°: 81.4 vs. 50.1 mL,
< 0.001; 0°: 88.3 vs. 57.1 mL,
< 0.001). Relative changes in SV (∆SV) after each tilt measured using PF were lower with a negative bias (PF vs. USCOM, 0° to 70°: -12.3% vs. -26.3%,
= 0.002; 70° to 30°: +6.4% vs. +31.2%,
< 0.001; 30° to 0°: +9.2% vs. +15.8%,
= 0.280). CO measurements using PF at 70° were erroneous. Compared with USCOM, PF overestimated SV measurements but underestimated the ∆SV between HUT. Accuracy of the PF deteriorated at 70°, implying a gravitational influence on its performance. These findings suggested that the suitability of PF for sports use is questionable.
The use of impedance cardiography to monitor physiological changes in sports is rarely reported. Using head-up tilt test, we evaluated a portable noninvasive impedance cardiography device (PhysioFlow) by comparing it with a reference Doppler monitor (USCOM). Accuracy in tracking hemodynamic changes deteriorated with higher tilt, implying a gravitational influence on its performance. Stroke volume measurements were overestimated, but the changes were underestimated. Despite its convenient physical features, the suitability of PhysioFlow for sports use is questionable.</description><subject>Athletes</subject><subject>Bias</subject><subject>Carbon monoxide</subject><subject>Cardiac output</subject><subject>Ethical standards</subject><subject>Gravity</subject><subject>Gravity effects</subject><subject>Heart rate</subject><subject>Hemodynamics</subject><subject>Performance evaluation</subject><subject>Sports</subject><subject>Stroke volume</subject><subject>Variance analysis</subject><issn>8750-7587</issn><issn>1522-1601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNpdkctqHDEQRUVIiCd2fiERZJNNT1TS9GsZTB4Gg7OI1021VPJo6G519AjMZ-SPLXucYLKqgjp1q-Aw9h7EFqCWnw64rtO6P0bnp60QnZRbKaB_wTZlKitoBLxkm66tRdXWXXvG3sR4EAJ2uxpeszMlJSgAtWF_flCwPsy4aOL0G6eMyfmFe8uRrz4kHCfio_NuXsk8UhqDcai5z2nNic9-cckHXlL4TBhzcMsd39PszXHB2Wmu97jcUeRu4Zj2E6XSmxOGBURT5ZUnNyVeJumCvbI4RXr7VM_Z7dcvPy-_V9c3364uP19XWvUiVY3F3rSNgkYCgJWGmtFATUL1egSLNe1GNKpDSVLqTo-6H8HIRllLKG2nztnHU-4a_K9cDg-zi5qmCRfyOQ5SdTvou162Bf3wH3rwOSzlu0L1bQtKQFOo9kTp4GMMZIc1uBnDcQAxPFgbnlsbHq0ND9bK5run_DzOZP7t_dWk7gEtgJr8</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Cheung, Cara H Y</creator><creator>Khaw, May L</creator><creator>Tam, Victor C W</creator><creator>Ying, Michael T C</creator><creator>Lee, Shara W Y</creator><general>American Physiological Society</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5257-2076</orcidid></search><sort><creationdate>20200501</creationdate><title>Performance evaluation of a portable bioimpedance cardiac output monitor for measuring hemodynamic changes in athletes during a head-up tilt test</title><author>Cheung, Cara H Y ; Khaw, May L ; Tam, Victor C W ; Ying, Michael T C ; Lee, Shara W Y</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-6fa9d763162111f2de6bd15e039cb1fa5e4bad38a2e22c8cbc9b1d263ffea2f83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Athletes</topic><topic>Bias</topic><topic>Carbon monoxide</topic><topic>Cardiac output</topic><topic>Ethical standards</topic><topic>Gravity</topic><topic>Gravity effects</topic><topic>Heart rate</topic><topic>Hemodynamics</topic><topic>Performance evaluation</topic><topic>Sports</topic><topic>Stroke volume</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheung, Cara H Y</creatorcontrib><creatorcontrib>Khaw, May L</creatorcontrib><creatorcontrib>Tam, Victor C W</creatorcontrib><creatorcontrib>Ying, Michael T C</creatorcontrib><creatorcontrib>Lee, Shara W Y</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of applied physiology (1985)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheung, Cara H Y</au><au>Khaw, May L</au><au>Tam, Victor C W</au><au>Ying, Michael T C</au><au>Lee, Shara W Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Performance evaluation of a portable bioimpedance cardiac output monitor for measuring hemodynamic changes in athletes during a head-up tilt test</atitle><jtitle>Journal of applied physiology (1985)</jtitle><addtitle>J Appl Physiol (1985)</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>128</volume><issue>5</issue><spage>1146</spage><epage>1152</epage><pages>1146-1152</pages><issn>8750-7587</issn><eissn>1522-1601</eissn><abstract>Cardiac output (CO) monitoring is useful for sports performance training, but most methods are unsuitable as they are invasive or hinder performance. The performance of PhysioFlow (PF), a portable noninvasive transthoracic bioimpedance CO monitor, was evaluated and compared with a reference Doppler CO monitor, USCOM, using a head-up tilt (HUT) test. With ethics committee approval, 20 healthy well-trained athletes were subjected to HUT in a fixed order of 0°, 70°, 30°, and 0° for 3 min each. Simultaneous hemodynamic measurements using PF and USCOM were made 30 s after a change in HUT and analyzed using
tests, ANOVA, and mountain plots. Heart rate (HR) and stroke volume (SV) from both monitors changed according to physiological expectation of tilt, but PF measurements of SV were higher with a positive bias (PF vs. USCOM, 0°: 87.3 vs. 54.0 mL,
< 0.001; 70°: 76.5 vs. 39.5 mL,
< 0.001; 30°: 81.4 vs. 50.1 mL,
< 0.001; 0°: 88.3 vs. 57.1 mL,
< 0.001). Relative changes in SV (∆SV) after each tilt measured using PF were lower with a negative bias (PF vs. USCOM, 0° to 70°: -12.3% vs. -26.3%,
= 0.002; 70° to 30°: +6.4% vs. +31.2%,
< 0.001; 30° to 0°: +9.2% vs. +15.8%,
= 0.280). CO measurements using PF at 70° were erroneous. Compared with USCOM, PF overestimated SV measurements but underestimated the ∆SV between HUT. Accuracy of the PF deteriorated at 70°, implying a gravitational influence on its performance. These findings suggested that the suitability of PF for sports use is questionable.
The use of impedance cardiography to monitor physiological changes in sports is rarely reported. Using head-up tilt test, we evaluated a portable noninvasive impedance cardiography device (PhysioFlow) by comparing it with a reference Doppler monitor (USCOM). Accuracy in tracking hemodynamic changes deteriorated with higher tilt, implying a gravitational influence on its performance. Stroke volume measurements were overestimated, but the changes were underestimated. Despite its convenient physical features, the suitability of PhysioFlow for sports use is questionable.</abstract><cop>United States</cop><pub>American Physiological Society</pub><pmid>32213113</pmid><doi>10.1152/japplphysiol.00822.2019</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-5257-2076</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of applied physiology (1985), 2020-05, Vol.128 (5), p.1146-1152 |
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| source | American Physiological Society; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Athletes Bias Carbon monoxide Cardiac output Ethical standards Gravity Gravity effects Heart rate Hemodynamics Performance evaluation Sports Stroke volume Variance analysis |
| title | Performance evaluation of a portable bioimpedance cardiac output monitor for measuring hemodynamic changes in athletes during a head-up tilt test |
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