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dc.contributor.authorMasini, Giulia
dc.contributor.authorFoo, Lin F
dc.contributor.authorCornette, Jérôme
dc.contributor.authorTay, Jasmine
dc.contributor.authorRizopoulos, Dimitris
dc.contributor.authorMcEniery, Carmel
dc.contributor.authorWilkinson, Ian
dc.contributor.authorLees, Christoph C
dc.date.accessioned2018-12-05T00:31:08Z
dc.date.available2018-12-05T00:31:08Z
dc.date.issued2019-05
dc.identifier.issn1355-6037
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286324
dc.description.abstractOBJECTIVES: We aimed to describe cardiac output (CO) trend from prepregnancy to post partum using an inert gas rebreathing (IGR) device and compare these measurements with those obtained by a pulse waveform analysis (PWA) technique, both cross-sectionally and longitudinally. METHODS: Non-smoking healthy women, aged 18-44 years, with body mass index <35 were included in this prospective observational study. CO measurements were collected at different time points (prepregnancy, at four different gestational epochs and post partum) using IGR and PWA. A linear mixed model analysis tested whether the longitudinal change in CO differed between the techniques. Bland-Altman analysis and intraclass correlation coefficient (ICC) were used for cross-sectional and a four-quadrant plot for longitudinal comparisons. RESULTS: Of the 413 participants, 69 had a complete longitudinal assessment throughout pregnancy. In this latter cohort, the maximum CO rise was seen at 15.2 weeks with IGR (+17.5% from prepregnancy) and at 10.4 weeks with PWA (+7.7% from prepregnancy). Trends differed significantly (p=0.0093). Cross-sectional analysis was performed in the whole population of 413 women: the mean CO was 6.14 L/min and 6.38 L/min for PWA and IGR, respectively, the percentage of error was 46% and the ICC was 0.348, with similar results at all separate time points. Longitudinal concordance was 64%. CONCLUSIONS: Despite differences between devices, the maximum CO rise in healthy pregnancies is more modest and earlier than previously reported. The two methods of CO measurement do not agree closely and cannot be used interchangeably. Technique-specific reference ranges are needed before they can be applied in research and clinical settings.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherBMJ
dc.subjectHumans
dc.subjectPregnancy Complications, Cardiovascular
dc.subjectBreath Tests
dc.subjectCardiac Output
dc.subjectProspective Studies
dc.subjectCross-Sectional Studies
dc.subjectReproducibility of Results
dc.subjectPostpartum Period
dc.subjectPregnancy
dc.subjectReference Values
dc.subjectAdolescent
dc.subjectAdult
dc.subjectFemale
dc.subjectYoung Adult
dc.titleCardiac output changes from prior to pregnancy to post partum using two non-invasive techniques.
dc.typeArticle
prism.endingPage720
prism.issueIdentifier9
prism.publicationDate2019
prism.publicationNameHeart
prism.startingPage715
prism.volume105
dc.identifier.doi10.17863/CAM.33634
dcterms.dateAccepted2018-10-04
rioxxterms.versionofrecord10.1136/heartjnl-2018-313682
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-05
dc.contributor.orcidMcEniery, Carmel [0000-0003-3636-0705]
dc.contributor.orcidWilkinson, Ian [0000-0001-6598-9399]
dc.identifier.eissn1468-201X
rioxxterms.typeJournal Article/Review
pubs.funder-project-idBritish Heart Foundation (None)
pubs.funder-project-idBritish Heart Foundation (None)
pubs.funder-project-idBritish Heart Foundation (None)
cam.issuedOnline2018-10-30
rioxxterms.freetoread.startdate2019-10-30


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