Abstract
Objective
Monitoring of patient's intravascular volume status without invasive measures remains
challenging and unreliable. Our objective was to determine if corrected flow time
(FTc) measurement could detect preload reduction with administration of nitroglycerin
(NTG) as a surrogate for volume loss.
Methods
Post hoc FTc analysis was performed for a prospective cohort study of pulsed wave
spectral Doppler measurements before and after administration of NTG. Patients enrolled
were eligible for inclusion if they were admitted to a chest pain center for cardiac
evaluation. Descriptive statistics, t tests, bivariate regression, and intraclass correlation coefficient were performed
as appropriate.
Results
Fifty-four patients had Doppler measurements available for review. Mean FTc decreased
from 339 milliseconds (95% confidence interval, 332-346) to 325 milliseconds (95%
confidence interval, 318-331) with administration of 0.3 mg of sublingual NTG (P = .0001). Mean heart rate increased 5 beats/min with administration of NTG (P < .0001); however, there was no significant change in systolic or diastolic blood pressure.
Conclusion
Corrected flow time was able to detect a significant difference in preload reduction
with 0.3 mg of NTG. The FTc may be an early reliable noninvasive measure to detect
changes in intravascular volume status.
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Article Info
Publication History
Published online: June 24, 2016
Accepted:
June 16,
2016
Received in revised form:
June 16,
2016
Received:
February 4,
2016
Footnotes
â?†Funding acknowledgments: the original prospective study was a grant-funded investigation provided by Women's Health Research at Yale. The post hoc analysis was conducted without any direct funding or support.
��Presentation of work (oral presentation accepted): American Institute of Ultrasound in Medicine, Annual Convention, March 19, 2016, New York, NY.
â?…Data: this research was produced from a prospective study on microvascular dysfunction.
â?…[1] Safdar B, Ali A, D'Onofrio G, Katz SD. Microvascular dysfunction as opposed to conduit artery disease explains sex-specific chest pain in emergency department patients with low to moderate cardiac risk. Clin Ther 2016. doi:10.1016/j.clinthera.2015.12.010.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
