Clinical application of non-invasive hemodynamic monitoring in the field of cardiovascular disease

Cardiovascular diseases, including hypertension and coronary heart disease, are characterized by high incidence rate and high mortality. Patients need to be diagnosed in time for reasonable and scientific treatment. Non invasive hemodynamics monitors pulse waves to obtain multiple indicators of the heart, such as cardiac output, stroke volume, heart rate, etc., which can help doctors detect small changes in the patient's condition in a timely manner and adjust treatment plans; Non invasive hemodynamic monitoring has the advantages of real-time, non-invasive, and continuous monitoring, and has become an important means of auxiliary examination for cardiovascular diseases. This article provides a review of the clinical application of non-invasive hemodynamic monitoring in cardiovascular diseases.

Hypertension is a chronic disease in which the pressure on the blood vessel wall caused by the flow of blood in the blood vessels remains higher than normal. It is also the main risk factor for cardiovascular and cerebrovascular diseases and can cause functional damage to organs such as the heart, brain, and kidneys. Hypertension can lead to damage to target organs such as the heart, brain, and kidneys, resulting in abnormalities in cardiac output, peripheral resistance, and arterial compliance, which can be reflected by hemodynamic parameters. Silva et al. detected non-invasive hemodynamic indicators and found that blood flow parameters in hypertensive patients were better than those in hypertensive patients with heart failure. Bergo et al. used refractory hypertension patients as the experimental group and ordinary hypertension patients as the control group. After taking the same hypertension medication, the results showed that the systemic vascular resistance index and blood pressure of the experimental group were lower than those of the control group. Nazario et al. evaluated the consistency between non-invasive hemodynamic indicators and transthoracic echocardiography, and the results showed that non-invasive hemodynamic indicators such as cardiac output, cardiac output index, pre ejection phase, left ventricular ejection time, systolic time ratio, and transthoracic echocardiography were consistent. Kahonen et al. evaluated the correlation between systemic vascular resistance index, heart rate and hypertension, and found that systemic vascular resistance index is an important predictor of hypertension independent of other risk factors, which can predict the incidence rate of hypertension in young people. Kurpaska et al. conducted exercise capacity (cardiopulmonary exercise test, 6-minute walk test) and hemodynamic tests on 98 hypertensive patients, and the results showed that the degree of impairment of hemodynamic indicators was negatively correlated with exercise capacity. The above results indicate that non-invasive hemodynamic monitoring is helpful in evaluating the condition of hypertensive patients, predicting the risk of hypertension, and providing a basis for the development of antihypertensive treatment plans.

Coronary heart disease is a heart disease caused by stenosis or occlusion of the coronary artery lumen, which can cause hemodynamic and cardiac dysfunction. Real time monitoring of hemodynamics in patients with coronary heart disease is beneficial for guiding physicians to develop treatment plans for coronary heart disease and evaluate treatment efficacy. Kurpaska et al. evaluated the early postoperative exercise ability of 54 patients with coronary heart disease undergoing myocardial revascularization using cardiopulmonary exercise tests and non-invasive educational mobility indicators. The parameters measured by cardiopulmonary exercise tests were oxygen intake, while those measured by hemodynamics included heart rate, cardiac output, etc. It was found that most patients had decreased oxygen intake and hemodynamic parameters, and the two were positively correlated. Qin Shaoqiang et al. selected 125 patients with coronary heart disease and unstable angina pectoris as the research subjects. Non invasive hemodynamic monitors were used to monitor the hemodynamic parameters of patients before and after percutaneous coronary intervention, including cardiac output, cardiac output index, stroke volume index, and left ventricular ejection fraction. The degree of coronary artery disease in patients was divided into mild and moderate groups based on the Gensini score. Pearson test was used to analyze the correlation between Gensini score and hemodynamic parameters in patients with coronary heart disease and unstable angina pectoris. The results showed that all hemodynamic parameters in patients with coronary heart disease and unstable angina pectoris were significantly lower after treatment than before treatment; The Gensini score of patients is negatively correlated with cardiac output, stroke volume, cardiac volume index, and left ventricular ejection fraction. The non-invasive hemodynamic monitor is helpful for dynamically monitoring the hemodynamic status of patients with coronary heart disease and unstable angina before and after percutaneous coronary intervention, and can be used as a reliable indicator to evaluate the severity of vascular lesions in patients.

Heart failure refers to a serious heart disease in which the pumping function of the heart is weakened, unable to meet the metabolic needs of various organs and tissues in the body, resulting in poor blood circulation and impaired organ function. Hemodynamic monitoring helps physicians determine the condition and staging of heart failure patients, and improve treatment effectiveness. Xi Xianping selected 30 patients with hypertension and heart failure as the research subjects, all of whom underwent non-invasive hemodynamic and brain natriuretic peptide (BNP) level measurements. It was found that as the BNP level in the blood of heart failure patients increased, their atrial systolic wave amplitude, diastolic function index, pulmonary artery wedge pressure, and total peripheral resistance levels all increased. The cardiac work per stroke, stroke work index, cardiac work per minute, ventricular systolic wave amplitude, stroke output, cardiac output, cardiac output index, and cardiac contractility index all decreased, indicating that non-invasive hemodynamic combined with BNP level detection can accurately evaluate the changes in the condition of patients with hypertension and heart failure. Bi Xiaofeng et al. selected 215 patients with acute heart failure as the research subjects and divided them into acute heart failure group and non acute heart failure group. Logistic regression analysis was used to explore the factors affecting the prognosis of acute heart failure. It was found that the variability of stroke volume was an independent predictor of 30 day mortality in patients. For every 1% increase in variability of stroke volume, the 30 day mortality rate increased by 0.2% to 2.9%, indicating that non-invasive hemodynamic monitoring has certain reference value for predicting the prognosis of patients with acute heart failure. Dong Nengbin et al. studied 100 patients with heart failure and conducted personalized treatment. Non invasive hemodynamic evaluations (heart rate, systolic blood pressure, diastolic blood pressure, cardiac output, cardiac output index, stroke volume, left ventricular ejection fraction) were performed on patients before and 5 days after treatment. The results showed that various hemodynamic indicators improved significantly after treatment, indicating that non-invasive hemodynamic monitoring can accurately evaluate the hemodynamic situation of heart failure patients and provide a basis for treatment.

Cardiogenic shock refers to a syndrome characterized by a significant decrease in cardiac output and severe acute peripheral circulatory failure due to extreme decline in cardiac function. The non-invasive hemodynamic monitor can monitor the cardiac output and volume load of patients with cardiogenic shock, providing important guidance for early diagnosis and treatment of their condition. Wei Hui et al. used non-invasive hemodynamic monitoring to monitor cardiac output index and peripheral vascular resistance in patients with acute myocardial infarction complicated by cardiogenic shock. The results showed that with prolonged treatment time, peripheral vascular resistance, chest fluid level, and serum BNP level decreased, while cardiac output index increased. The chest fluid level was positively correlated with serum BNP concentration, proving that non-invasive hemodynamic detection technology is helpful in evaluating the efficacy of patients with acute myocardial infarction complicated by cardiogenic shock.

Summary and Prospect

Non invasive hemodynamic monitoring has the advantages of safety, non invasiveness, continuous monitoring, easy operation, and economy. It can monitor the mechanical contraction, relaxation, and output of the heart in real time, achieve comprehensive evaluation of cardiac hemodynamics, and has high application value in the diagnosis and treatment evaluation of cardiovascular diseases such as hypertension, coronary heart disease, heart failure, and cardiogenic shock. With the development of medical technology, the monitoring system will be improved in the future to play a greater role in clinical work.