A Minimally Invasive Method for Beat-by-Beat Estimation of Cardiac Pressure-Volume Loops

This paper develops a minimally invasive means of estimating a patient-specific cardiac pressure-volume loop beat-to-beat. This method involves estimating the left ventricular pressure and volume waveforms using clinically available information including heart rate and aortic pressure, supported by a baseline echocardiography reading. Validation of the method was performed across an experimental data set spanning 5 Piétrain pigs, 46,318 heartbeats and a diverse clinical protocol. The method was able to accurately locate a pressure-volume loop, identifying the end-diastolic volume, end-systolic volume, mean-diastolic pressure and mean-systolic pressure of the ventricle with reasonable accuracy. While there were larger percentage errors associated with stroke work derived from the estimated pressure-volume loops, there was a strong correlation (average R value of 0.83) between the estimated and measured stroke work values. These results provide support for the potential of the method to track patient condition, in real-time, in a clinical environment. This method has the potential to yield additional information from readily available waveforms to aid in clinical

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