Decrease in Left Ventricular Ejection Time on Digital Arterial Waveform during Simulated Hypovolemia in Normal Humans

Authors:
  • PAPierre Albaladejo
    Pierre Albaladejo
  • ADAdrien Descorps Declère
    Adrien Descorps Declère
  • JDJacques Duranteau
    Jacques Duranteau
  • JSJean-Patrick Sales
    Jean-Patrick Sales
  • DBDan Benhamou
    Dan Benhamou
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Abstract
Left ventricular ejection time (LVET) measured in central arteries is modified during hypovolemia. We compared modifications of the pulse wave in a central artery (carotid) and in a peripheral artery (digital) during central hypovolemia induced by lower body negative pressure (LBNP) in conscious volunteers. Hypovolemia was simulated with progressive LBNP (baseline, −10, −20, and −30 mm Hg) in nine young healthy volunteers. The carotid arterial pressure waveform was recorded using a Millar tonometric method. The digital pulse wave was measured with a volume-clamp method (Finapres) and the stroke volume with a thoracic impedance method (Biomed). Mean arterial pressure did not change during LBNP. Compared with baseline values, heart rate increased significantly at the −30 mm Hg level (68 ± 13 beats/min vs. 59 ± 11 beats/min), and stroke volume decreased as soon as −10 mm Hg was achieved (113 ± 41 mL vs. 127 ± 35 mL). Both carotid and digital LVET decreased significantly at the −10 mm Hg level (337 ± 26 and 339 ± 24 ms vs. 360 ± 35 and 361 ± 24 ms, respectively). Peripheral LVET could reflect variation of central LVET during LBNP and be a reliable noninvasive parameter for monitoring hypovolemia.

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