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Echocardiographic assessment of aortic elastic properties with automated border detection in an ICU: in vivo application of the arctangent Langewouters model

¹Intensive Care Department, Ghent University Hospital, ²Hydraulics Laboratory, Institute of Biomedical Technology, and ³Department of Surgery and Anesthesiology of Domestic Animals, Ghent University, Ghent, Belgium

Submitted 13 May 2004 ; accepted in final form 14 December 2004

We studied whether combined pressure and transesophageal ultrasound monitoring is feasible in the intensive care unit (ICU) setting for global cardiovascular hemodynamic monitoring [systemic vascular resistance (SVR) and total arterial compliance (C_PPM)] and direct estimation of local ascending and descending aortic mechanical properties, i.e., distensibility and compliance coefficients (DC and CC). Pressure-area data were fitted to the arctangent Langewouters model, with aortic cross-sectional area obtained via automated border detection. Data were measured in 19 subjects at baseline, during infusion of sodium nitroprusside (SNP), and after washout. SNP infusion lowered SVR from 1.15 ± 0.40 to 0.80 ± 0.32 mmHg·ml^–1·s (P < 0.05), whereas C_PPM increased from 0.87 ± 0.46 to 1.02 ± 0.42 ml/mmHg (P < 0.05). DC and CC increased from 0.0018 ± 0.0007 to 0.0025 ± 0.0009 l/mmHg (P < 0.05) and from 0.0066 ± 0.0028 to 0.0083 ± 0.0026 cm²/mmHg (P < 0.05), respectively, at the descending, but not ascending, aorta. The Langewouters model fitted the descending aorta data reasonably well. Assessment of local mechanical properties of the human ascending aorta in a clinical setting by automated border detection remains technically challenging.

afterload; large artery function; nitroprusside; coronary artery bypass grafting; intensive care unit

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