Comparison of bioreactance and echocardiographic non-invasive cardiac output monitoring and myocardial function assessment in primagravida women

<span class="paragraphSection"><div class="boxTitle">Abstract</div><strong>Background.</strong> Non-invasive cardiac output monitoring (NICOM) using bioreactance (BRT) in pregnancy is gaining interest but lacks validation. We compared simultaneous cardiac output (CO) measurements obtained using the NICOM^® (BRT-CO) and echocardiography (echo-CO), and assessed the relationship between maternal characteristics and myocardial performance.<strong>Methods.</strong> Paired stroke volume (SV) and CO readings were obtained using NICOM^® and echocardiography, in a group of healthy nulliparous women throughout a 15 min period. Agreement between NICOM^® and echocardiography was assessed using Bland–Altman analysis and the intraclass correlation coefficient (ICC). Left ventricular (LV) function was assessed using systolic strain and tissue Doppler velocities (S′, E′, and A′ waves).<strong>Results.</strong> Thirty-five women with a median [interquartile range] age, weight, and gestation of 29 [26–34] yr, 71 [64–79] kg, and 28 [21–29] weeks, respectively, were enrolled. There was good agreement between NICOM^®-measured and echocardiographically measured SV [mean bias 6 ml (limits of agreement −18 to 29); ICC 0.8 (95% confidence interval 0.6–0.9), <span style="font-style:italic;">P</span><0.001] and CO [mean bias 0.2 litres (limits of agreement −1.3–1.7); ICC 0.8 (95% confidence interval 0.7–0.9), <span style="font-style:italic;">P</span><0.001; mean percentage error ±26%; coefficient of error (precision)=3.4%]. The mean (<span style="text-transform:lowercase;font-variant:small-caps;">sd</span>) LV S′ was 9.7 (2.3) cm s⁻¹. The mean (<span style="text-transform:lowercase;font-variant:small-caps;">sd</span>) LV strain was −18.6 (2.6)%. There was a negative relationship between BMI and LV diastolic function measured using the E′:A′ ratio (<span style="font-style:italic;">r</span> = −0.51, <span style="font-style:italic;">P</span><0.01).<strong>Conclusions.</strong> Stroke volume and CO measurements obtained using NICOM^® were comparable to those obtained using echocardiography, with acceptable limits of agreement. Increased maternal BMI negatively impacts LV diastolic function measured using tissue Doppler imaging.</span>

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