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Performance evaluation of a portable bioimpedance cardiac output monitor for measuring hemodynamic changes in athletes during a head-up tilt test

Cheung, CHY, Khaw, ML, Tam, VCW, Ying, MTC and Lee, SWY 2020 , 'Performance evaluation of a portable bioimpedance cardiac output monitor for measuring hemodynamic changes in athletes during a head-up tilt test' , Journal of Applied Physiology, vol. 128, no. 5 , pp. 1146-1152 , doi: 10.1152/japplphysiol.00822.2019.

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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 t 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, P P P P P = 0.002; 70° to 30°: +6.4% vs. +31.2%, P P = 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.NEW & NOTEWORTHY: 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.

Item Type: Article
Authors/Creators:Cheung, CHY and Khaw, ML and Tam, VCW and Ying, MTC and Lee, SWY
Keywords: doppler ultrasound cardiac output monitor, PhysioFlow, cardiac output, impedance cardiography, performance
Journal or Publication Title: Journal of Applied Physiology
Publisher: American Physiological Society
ISSN: 8750-7587
DOI / ID Number: 10.1152/japplphysiol.00822.2019
Copyright Information:

Copyright © 2020 the American Physiological Society

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