Evaluation of impedance cardiography (ICG) for assessing hemodynamic parameters in Fontan patients
| dc.contributor.author | Hassan-Tash, Seyed-Pedram | |
| dc.contributor.examiningcommittee | Czubryt, Michael (Physiology and Pathophysiology) | en_US |
| dc.contributor.examiningcommittee | Kirshenbaum, Lorrie (Physiology and Pathophysiology) | en_US |
| dc.contributor.supervisor | Ravandi, Amir | |
| dc.contributor.supervisor | Shah, Ashish | |
| dc.date.accessioned | 2022-05-03T14:38:42Z | |
| dc.date.available | 2022-05-03T14:38:42Z | |
| dc.date.copyright | 2022-05-02 | |
| dc.date.issued | 2022-05-02 | |
| dc.date.submitted | 2022-05-02T23:20:04Z | en_US |
| dc.degree.discipline | Physiology and Pathophysiology | en_US |
| dc.degree.level | Master of Science (M.Sc.) | en_US |
| dc.description.abstract | Introduction: Hemodynamic assessment using currently available methods is particularly challenging in the Fontan population. Patients with Fontan circulation are generally described to have chronically low cardiac output (CO) and high central venous pressure (CVP). Reduced exercise capacity is amongst many adverse effects associated with Fontan circulation. We set to firstly examine accuracy and reproducibility of a non-invasive technology in hemodynamic assessment and, secondly to evaluate resting, and post-exercise hemodynamics in patients with Fontan circulation using this non-invasive means. Material and method: In the first part of the project, forty-one patients undergoing cardiac magnetic resonance imaging (CMR), as part of their standard of clinical care, were investigated using NICaS 10 minutes prior to undergoing CMR. In the latter part, twenty-one patients with Fontan circulation and 21 age and sex matched healthy participants were assessed by cardiopulmonary exercise testing (CPET) using treadmill ergometer and breath gas analyzer. Their resting and post-exercise hemodynamic parameters were also measured using NICaS. Results: Data from 39 patients was available for comparison of CMR to ICG. 15/39 (39%) were female; mean ± SD age and body mass index (BMI) were 54 ± 15 years (range: 27 - 86 years) and 28.6 ± 5.5 kg/m2 (range: 20.5 - 41.9 kg/m2) respectively. NICaS derived SV strongly correlated with aortic forward flow measured by CMR, with Pearson correlation factor (r) of 0.78, and significance (p) of < 0.05. Fontan group showed a significantly lower mean peak oxygen consumption (peak VO2) compared to control (23.6 ± 5.5 vs. 43.2 ± 9 ml/Kg/min; p < 0.05). Fontan had a significantly higher ventilatory efficiency which is demonstrated as minute ventilation to carbon dioxide production ratio (VE/VCO2) (40 ± 5 vs. 32 ± 4; p < 0.05). Conclusion: NICaS derived SV demonstrated strong correlation with aortic forward flow volume assessment of CMR. NICaS additionally exhibited excellent reproducibility. Additionally, in later part of our work we found that our CPET and ICG assessments are in keeping with previously published data in the Fontan population. | en_US |
| dc.description.note | October 2022 | en_US |
| dc.identifier.uri | http://hdl.handle.net/1993/36466 | |
| dc.language.iso | eng | en_US |
| dc.rights | open access | en_US |
| dc.subject | Fonatn | en_US |
| dc.subject | Impedance cardiography | en_US |
| dc.subject | Cardiopulmonary exercise test | en_US |
| dc.subject | CMR | en_US |
| dc.subject | cardiac magnetic resonance | en_US |
| dc.subject | ICG | en_US |
| dc.subject | Hemodynamics | en_US |
| dc.title | Evaluation of impedance cardiography (ICG) for assessing hemodynamic parameters in Fontan patients | en_US |
| dc.type | master thesis | en_US |