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Continuous, Real Time, Non-Invasive Hemodynamic Cardiac Doppler Monitoring With a Novel Hands-Free Device: A Feasibility Study Compared to Standard Echo.

[+] Author and Article Information
Gilead I Lancaster

Department of Medicine (Cardiology), Bridgeport Hospital/Yale University School of Medicine, Bridgeport, Connecticut
pglanc@bpthosp.org

Ilan Hay

Cardiac Rehabilitation Institute, Sheba Medical Center, Tel Hashomer, Israel
ilanhay@yahoo.com

Michael Eldar

Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel
Michael.Eldar@sheba.health.gov.il

1Corresponding author.

ASME doi:10.1115/1.4036024 History: Received October 07, 2015; Revised December 27, 2016

Abstract

Objectives: This study sought to determine the feasibility of using Non-Invasive Cardiac Hemodynamics (NICHE), a new non-invasive Doppler-based device, to monitor real-time, simultaneous tissue and blood-flow Doppler measurements in a clinical setting, and to obtain preliminary performance data compared to a commercially available system. Background: Doppler based measurements have been shown to correlate well with invasive hemodynamic data and diastolic function, but their use in clinical applications have been limited by various technical issues. The NICHE device was developed to obtain simultaneous tissue and blood flow Doppler measurements automatically, in real time and in a hands-free manner. Methods: 30 participants (10 normal volunteers and 20 patients in a cardiac rehab program) underwent standard echocardiographic/Doppler studies followed immediately by NICHE monitoring. Early diastolic trans-mitral blood flow velocity (E) and tissue Doppler myocardial wall velocity during early relaxation (E’) were acquired using a standard echo device; and E/E’ was derived post hoc. NICHE measurements included E, E’ and directly measured instantaneous E/E’. Results: NICHE was successfully used in 28 participants. Measurements of ENICHE ranged from 40 cm/s to over 120 cm/s and correlated well with Eecho (R=0.93). E’NICHE ranged from 2 to 23 cm/s and correlated well with the averaged E’echo (R= 0.91). Directly measured E/E’NICHE ratios ranged from 3-23 and correlated well with derived E/E’echo (R= 0.91). Conclusions: The NICHE device can monitor patients in a hands-free manner and can supply real time Doppler derived measurements of hemodynamic parameters and diastolic function that correlate well with measurements from standard echo devices.

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