To demonstrate the calculations for Wei’s SV correction facto Pressure-Volume Transonic Scisense Technical Note cardiac cycle (End-Systole and End-Diastole as determined by A. Hentonand andtherefore F. Konecnyunique to any st Wei’s SV correction is dynamic March, 2013 variables used above in Baan’s SV correction will apply: Transonic Transonic Scisense Scisense Technical Technical Note Note L = 4.5 mm A mathematical review of SV correction factors employed in Baan’s ρ = 1.2 Ohm·m equation and Wei’s equation: Wei’s SV Correction: Scisense PV Technical Note Wei’s SV Correction: Transonic Scisense Technical Note A. Henton F. Konecny echocardiogra SVreference = 32uL (as derived fromand hi-resolution March, 2013 To demonstrate the calculations for Wei’s SV correction facto To demonstrate calculations for To demonstrate the calculations for Wei’s Wei’s SV SV correction correction facto facto Gb-ED = 855 uS =the 0.855 mS cardiac cycle (End-Systole and End-Diastole as determined by cardiac cycle (End-Systole and End-Diastole as determined cardiac cycle (End-Systole and End-Diastole as determined by by Baan’s equation: Where: Wei’s SV correction is dynamic and therefore unique to any st Gb-ES = 465 uS = 0.465 mS A mathematical review of SVρ =correction factors employed in Baan’s Wei’s SV correction is dynamic and therefore unique to any st blood resistivityWei’s SV correction is dynamic and therefore unique to any st variables used above in Baan’s SV correction will apply: variables used in SV will variables used above above in Baan’s Baan’s SV correction correction will apply: apply: L = measuring electrodes distance Transonic Scisense Technical Note equation and Wei’s equation: How Wei’s Equation Improves Volume Measurement Using Gamma Correction Factor 𝑆𝑆𝑆𝑆𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 The conversion of blood conductance to volume LL == 4.5 α = SV correction VARIABLES factor = mm 4.5 mm 1 −𝑏𝑏 ±√𝑏𝑏2 −4𝑎𝑎𝑎𝑎 L = 4.5 mm 𝐺𝐺 can be achieve by2employing a conversion equation 𝑏𝑏𝑆𝑆𝑆𝑆𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟 𝑉𝑉𝑉𝑉𝑉𝑉 = 𝜌𝜌𝜌𝜌 (𝐺𝐺 −G. ) �1 − � , 𝑤𝑤ℎ𝑒𝑒𝑒𝑒𝑒𝑒 γ = 𝑥𝑥 or Wei’s 𝑝𝑝 equation. ρ = blood resistivity Gx The = measured TOTAL such as Baan’s 𝛾𝛾Ohm·m Therefore, we can compare 𝛼𝛼 equation 2𝑎𝑎 SV correction process between B ρ == conductance 1.2 ρ 1.2 Ohm·m ρ = 1.2 Ohm·m primary difference in these equations is how the = parallel/muscle conductance L = measuring electrode distance Gp Baan’s equation: Where: 𝑆𝑆𝑆𝑆 stroke volume (SV) correction factor is treated. (assumed to be removed by hypertonic saline injection) ==SV 32uL (as derived from echocardiograp αSV = reference Baan’s correction factor = hi-resolution ( 𝑆𝑆𝑆𝑆𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 ) VS 32uL (as derived from hi-resolution echocardiograp reference SV (as derived from hi-resolution echocardiograp ρ = blood resistivitySV reference = 32uL 𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟 2 (𝐺𝐺 2 ) 𝑎𝑎 = 𝑆𝑆𝑆𝑆 − 𝜌𝜌𝐿𝐿 − 𝐺𝐺 32 − (1.2)(4.5) (0.8 Gx = measured Total conductance 𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 L = measuring electrodes distance Baan’s Equation Gb-ED = 855 uS = 0.855 mS Gb-ED = 855 uS = 0.855 mS we must recognize that Baan’s ‘alpha’ correction i = 855 uSBlood =However, 0.855 mS 𝑆𝑆𝑆𝑆 𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 GGb-ED conductance (separated b = measured α = SV correction factor = (𝐺𝐺 ) dynamic and defined by the following: a non-linear + 𝐺𝐺 𝑏𝑏 = −𝑆𝑆𝑆𝑆 · −32(0.855 + 0.465) =1 𝑆𝑆𝑆𝑆 𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 Note: for the purpose this document we will not use a hypertonic saline bolus process to calculate 𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟 from parallel/muscle conductance usinggamma, Gb-ES == 465 uS ==conductance 0.465 mS 𝑉𝑉𝑉𝑉𝑉𝑉 = 𝜌𝜌𝜌𝜌2 (𝐺𝐺𝑥𝑥of−G. ) measured throughout the cardiac cycle. There Gb-ES 465 uS 0.465 mS 𝑝𝑝 Gb-ES = 465 uS = 0.465 mS admittance phase measurement) = measured TOTAL conductance 𝛼𝛼 Vp to satisfy Baan’s equation.GxInstead the average we will employ the admittance correction process two processes it is best∙ to use a sample data set a 𝑐𝑐 = 𝑆𝑆𝑆𝑆 · 𝐺𝐺 · 𝐺𝐺correction 32(0.855 0.465) = 12.7224 𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 conductance = parallel/muscle conductance Gp this we canGbetter = Baan’s parallel/muscle (assumed reliant on phase shift measurement. By doing compare resulting volume p For the purpose of this document we will not use The saline following guideline shows how to compare the SV corre toby behypertonic removed by hypertonic saline injection) (assumed to be removed injection) 2 derived each Baan’s and Wei’s of each unique SV a measurements hypertonic saline bolusbyprocess to calculate theequations and 𝐺𝐺understand the effect −𝑏𝑏 ±√𝑏𝑏 −4𝑎𝑎𝑎𝑎 2 𝑏𝑏 𝐺𝐺 −𝑏𝑏 ±√𝑏𝑏 ±√𝑏𝑏2 −4𝑎𝑎𝑎𝑎 −4𝑎𝑎𝑎𝑎 In Wei’s 𝐺𝐺𝑏𝑏 �1 − ��can ,, 𝑤𝑤ℎ𝑒𝑒𝑒𝑒𝑒𝑒 γγ == −𝑏𝑏 average Gp factor. to satisfy Baan’s equation. Instead 𝑏𝑏equation: correction Therefore, after satisfying Vpwe by admittance we understand Baan’s2𝑎𝑎 equation as: �1 − 𝑤𝑤ℎ𝑒𝑒𝑒𝑒𝑒𝑒 𝛾𝛾 �1 − � , 𝑤𝑤ℎ𝑒𝑒𝑒𝑒𝑒𝑒 γ = 𝛾𝛾 2𝑎𝑎 will employ the admittance correction process 𝛾𝛾 2𝑎𝑎baseline data2set Step 1: Select stable −𝑏𝑏 ±√𝑏𝑏2 −4𝑎𝑎𝑎𝑎 42.24 ±�−42.24 −4(22.5230 ∙ 12.7 reliant on phase shift measurement. By doing γ = Note: for 1 the purpose of this document we will not use a hypertonic saline bolus process to calculate 2(22.5230) this we can better2compare resulting volume 2𝑎𝑎 𝑉𝑉𝑉𝑉𝑉𝑉 = Vp 𝜌𝜌𝜌𝜌 (𝐺𝐺𝑏𝑏by )Baan’s the average to satisfy equation. the admittance correction process 2 2 measurements derived each Baan’s and Instead Wei’s we will 𝑎𝑎employ )) 2 2 = 𝑆𝑆𝑆𝑆 − 𝜌𝜌𝐿𝐿 − 𝐺𝐺 32 − (1.2)(4.5) 2 (𝐺𝐺 𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 2 (0.8 𝛼𝛼 (𝐺𝐺 𝑎𝑎 = 𝑆𝑆𝑆𝑆 − 𝜌𝜌𝐿𝐿 − 𝐺𝐺 32 − (1.2)(4.5) (0.8 (𝐺𝐺 ) 𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 𝑎𝑎 = 𝑆𝑆𝑆𝑆 − 𝜌𝜌𝐿𝐿 − 𝐺𝐺 32 − (1.2)(4.5) (0.8 𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 equations and understand the effect of each reliant on phase shift measurement. By doing this we can Note: better compare resulting volume Wei’s equation always uses the larger postive solu unique SV correction factor. Therefore, after measurements derived by each Baan’s and Wei’s equations and understand the+ of) each unique SV + 𝐺𝐺 𝑏𝑏 = −𝑆𝑆𝑆𝑆 · (𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 −32(0.855 ) +effect 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏 −32(0.855 + 0.465) 0.465) == -(𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 satisfying Gp by admittance we can understand 𝑏𝑏 = = −𝑆𝑆𝑆𝑆 −𝑆𝑆𝑆𝑆 ·· (𝐺𝐺 𝑏𝑏−𝐸𝐸𝐸𝐸 + 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 ) −32(0.855 + 0.465) = correction factor. Therefore, after satisfying Vp by admittance we can understand Baan’s equation as: Baan’s equation as: 𝑐𝑐𝑐𝑐 = 𝑆𝑆𝑆𝑆 ·· 𝐺𝐺 ·· 𝐺𝐺 32(0.855 32(0.855 ∙∙ 0.465) 0.465) == 12.7224 Wei’s Equation: Where: 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 12.7224 𝑏𝑏−𝐸𝐸𝐸𝐸 𝑐𝑐 = = 𝑆𝑆𝑆𝑆 𝑆𝑆𝑆𝑆 · 𝐺𝐺 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 · 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 32(0.855 ∙ 0.465) = 12.7224 1 2 ρ = blood resistivity 𝑉𝑉𝑉𝑉𝑉𝑉 = 𝜌𝜌𝜌𝜌 (𝐺𝐺𝑏𝑏 ) L = measuring electrodes distance However, we must recognize that Baan’s ‘alpha’ 𝛼𝛼 correction is a constant, while Wei’s correction conductance Gb = measured BLOOD 2 2 −4(22.5230 ∙ 12.7 −𝑏𝑏 ±√𝑏𝑏 2 42.24 ±�−42.24 2 is dynamic and defined by the 2 −4𝑎𝑎𝑎𝑎 −𝑏𝑏 ±√𝑏𝑏 −4𝑎𝑎𝑎𝑎 2 −4(22.5230 42.24 ±�−42.24 (calculated usingfactor admittance process, involving removal of following: −𝑏𝑏 ±√𝑏𝑏 −4𝑎𝑎𝑎𝑎 42.24 ±�−42.24 −4(22.5230 ∙∙ 12.7 12.7 γ = γ = gamma, a non-linear constant and G , the unique = 2(22.5230) 2𝑎𝑎 Wei’s Equation b 2(22.5230) parallel/muscle conductance 2𝑎𝑎 using phase measurement) 2(22.5230) 2𝑎𝑎 conductance measured throughout value of blood 2 −4𝑎𝑎𝑎𝑎 −𝑏𝑏 ±√𝑏𝑏 Wei’s Equation: Where: the cardiac cycle. Therefore, it is our opinion that 1 2 γ= Note: Wei’s equation always uses the larger postive solu 𝑉𝑉𝑉𝑉𝑉𝑉 = compare these two correction processes it is best Note: Wei’s equation always the postive 2𝑎𝑎 to ρ = blood resistivity 𝐺𝐺𝑏𝑏 𝜌𝜌𝜌𝜌 (𝐺𝐺𝑏𝑏 ) Note: Wei’s equation always uses uses the larger larger postive solu solu (1− ) to use a distance sample data set and follow the process of L = measuring electrodes 𝛾𝛾 where, each equation. = measured BLOOD conductance GA.bHenton Transonic Scisense Technical Note and F. Konecny March, 2013 (calculated using admittance process, involving removal of 2 (𝐺𝐺 SV Correction Factors 𝑎𝑎 = 𝑆𝑆𝑆𝑆 − 𝜌𝜌𝜌𝜌 𝑏𝑏𝑏𝐸𝐸𝐸𝐸 − 𝐺𝐺𝑏𝑏𝑏𝐸𝐸𝐸𝐸 ) parallel/muscle conductance using phase measurement) We can compare SV correction process between Therefore, we can compare SV correction process between Baan’s and following: Wei’s equations by±√𝑏𝑏 the following: 2 −4𝑎𝑎𝑎𝑎 𝑏𝑏 =−𝑏𝑏 −𝑆𝑆𝑆𝑆 · (𝐺𝐺 Baan’s and Wei’s by the 𝑏𝑏𝑏𝐸𝐸𝐸𝐸 + 𝐺𝐺𝑏𝑏𝑏𝐸𝐸𝐸𝐸 ) 1 equations 2 γ= 𝑉𝑉𝑉𝑉𝑉𝑉 = 𝐺𝐺 𝜌𝜌𝜌𝜌 (𝐺𝐺𝑏𝑏 ) 𝐺𝐺𝑏𝑏 𝑐𝑐 = 𝑆𝑆𝑆𝑆 · 𝐺𝐺2𝑎𝑎 𝑆𝑆𝑆𝑆 𝑏𝑏𝑏𝐸𝐸𝐸𝐸 · 𝐺𝐺𝑏𝑏𝑏𝐸𝐸𝐸𝐸 (1− )𝑏𝑏 ) VS ( 𝑆𝑆𝑆𝑆𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 𝛾𝛾 𝛾𝛾 𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟 where, (1 − ) However, we must recognize that Baan’s ‘alpha’ correction is a constant, while Wei’s correction factor is 𝑎𝑎 = 𝑆𝑆𝑆𝑆 − 𝜌𝜌𝜌𝜌2 (𝐺𝐺𝑏𝑏𝑏𝐸𝐸𝐸𝐸 − 𝐺𝐺𝑏𝑏𝑏𝐸𝐸𝐸𝐸 ) dynamic and defined by the following: gamma, a non-linear constant, and Gb, the unique value of blood onductance measured throughout the cardiac cycle. Therefore, it is our opinion that to compare these 𝑏𝑏 = −𝑆𝑆𝑆𝑆 · (𝐺𝐺𝑏𝑏𝑏𝐸𝐸𝐸𝐸 + 𝐺𝐺𝑏𝑏𝑏𝐸𝐸𝐸𝐸 ) wo correction processes it is best to use a sample data set and follow the process of each equation. RPV-1-tn Rev. A 6/13 = 𝑆𝑆𝑆𝑆 · 𝐺𝐺software. The following guideline shows how to compare the SV correction processes using𝑐𝑐LabScribe2 𝑏𝑏𝑏𝐸𝐸𝐸𝐸 · 𝐺𝐺𝑏𝑏𝑏𝐸𝐸𝐸𝐸 Pressure-Volume Wei’s Equation Gamma Correction Factor Cont. The following guideline shows how to compare the SV correction processes using LabScribe2 software. First select a stable baseline data set to provide the values for the equation comparison. Using the “Function” tool, create a new channel for “Blood Conductance” After selecting “Blood Conductance” a dialog box will appear (pictured below). Complete the “Settings” for Magnitude, Phase, Species and Sigma/Epsilon, also referred to as ‘Heart Type’ in current ADV500/ADVantage 5.0 systems. In this file, the standard for healthy tissue was used (S/E = 800,000 units) Pressure-Volume Wei’s Equation Gamma Correction Factor Cont. Using the “Function” tool on the Pressure Channel, create a new calculated channel for dP/dt. In the “Analysis View”, use the vertical cursors to highlight maximum and minimum dP/dt points to determine corresponding measurements Gb-ED and Gb-ES, respectively. Now that we have measured both Gb-ED and Gb-ES, we can satisfy both SV correction formulas (also using the common measurements for electrode distance (L), blood resistivity (ρ), and SVreference). units out): ρ = cancel 1.2 Ohm·m Pressure-Volume L =SV 4.5 mm reference = 32uL (as derived from hi-resolution echocardiography) Transonic Scisense Technical Note Transonic Scisense Technical Note ρ =Gb-ED 1.2 Ohm·m = 855 uS = 0.855 mS SVGb-ES 32uLuS(as derived reference==465 = 0.465 mSfrom hi-resolution echocardiography) A. Henton and F. Konecny 2013 A. Henton andMarch, F. Konecny March, 2013 Wei’s= 855 SV uS Correction: Gb-ED = 0.855 mS Wei’s SV Correction: Wei’s Equation Gamma Correction Cont. To demonstrate the calculations for Wei’s SV correction factor, we will Factor use two sample points in the Gb-ES = 465 uS = 0.465 mS 2 is required To demonstrate the calculations for Wei’s SVascorrection we will use twopoints). sample This points in the as cardiac cycle (End-Systole and(𝐺𝐺End-Diastole determined by(0.855−0.465)(1.2)(4.5) dP/dt inflection 𝑆𝑆𝑆𝑆𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 −𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 )𝜌𝜌𝐿𝐿2 factor, 𝑏𝑏−𝐸𝐸𝐸𝐸 ( ) ( ) = cardiac (End-Systole and End-Diastole asunique determined dP/dt required as Wei’s𝑆𝑆𝑆𝑆 SVcycle correction is dynamic and to anybystage ofinflection the cardiac cycle. This The is same 𝑆𝑆𝑆𝑆therefore 32 points). 𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟 𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟 Baan’s SV Correction Wei’s SV correction dynamic therefore will unique to any stage of the cardiac cycle. The same variables used aboveis in Baan’s and SV correction apply: 0.2962 Transonic Scisense Technical Note 2 2 variables used above in Baan’s SV correction 𝑆𝑆𝑆𝑆𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐𝑐 (𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 −𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸will )𝜌𝜌𝐿𝐿apply: (0.855−0.465)(1.2)(4.5) Transonic Scisense Technical Note L = 4.5 mm 0.2962 ( )( ) = 𝑆𝑆𝑆𝑆 𝑆𝑆𝑆𝑆 32 𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟 𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟𝑟 L = 4.5 mm ρ = 1.2 Ohm·m 0.2962 Referring to Baan’s complete equation, the SV correction factor Datafactor Point 1 (End-Diastole): VALUES OF VARIABLES ρ = 1.2 Ohm·m as follows: isReferring expressedto asBaan’s follows:complete equation, the SV correction Data Pointis1expressed (End-Diastole): SVreference = 32uL (as derived from hi-resolution echocardiography) L = 4.5 mm SV = 32uL (as derived from hi-resolution echocardiography) Remembering that Wei’s SV correction factor is dynamic an reference 1 1 = 1.2 Ohm·m Remembering thatρ Wei’s SV correction factor is dynamic an Gb-ED 0.855 mS 3.376 = 855 uS = = 3.376 measurement of blood conductance (Gderived b) during the cardiac 𝛼𝛼 0.2962 SV = 32μL (as(G from Gb-ED = 855 uS = 0.855 mS reference Referring to Baan’s complete equation, the SV correctionmeasurement factor is expressed as follows: of blood conductance b) during the cardiac specific SV correction at any one point in the cardiac cycle. hi-resolution echocardiography) Gb-ES = 465 uS = 0.465 mS specific SV correction at any one point in the cardiac cycle. Therefore, every measured value of blood conductance during the cardiac cycle will be that would occur at ED: = 855 μS = 0.855 mS 1Gb-ES = 465 1 uS = 0.465 mS Gb-ED Wei’s SV Correction 3.376 multiplied by = +3.376. that would occur at ED: Gb-ES = 465 μS = 0.465 mS 𝐺𝐺𝑏𝑏 0.855 To demonstrate the calculations Wei’s SV correction factor, −𝑏𝑏 ±√𝑏𝑏2for −4𝑎𝑎𝑎𝑎 � �1 − = 0.4294 �1 − we 𝐺𝐺𝑏𝑏 𝐺𝐺 0.855 �Units Note: must be used as 𝑏𝑏 𝛾𝛾 � �1 − 1.4984 will use two sample points invalue the cardiac cycle (End-Systoleduring and End�1 − � , 𝑤𝑤ℎ𝑒𝑒𝑒𝑒𝑒𝑒 γ = �1 − � =tobe 0.4294 2 Therefore, every measured of blood conductance the cardiac cycle will −𝑏𝑏 ±√𝑏𝑏 −4𝑎𝑎𝑎𝑎 𝛾𝛾𝑏𝑏 provided properly cancel out. 1.4984 𝛾𝛾 𝐺𝐺 2𝑎𝑎 Diastole determined �1 − 𝛾𝛾 �as,by 𝑤𝑤ℎ𝑒𝑒𝑒𝑒𝑒𝑒 γ = by dP/dt inflection points). This is required as multiplied +3.376. Referring Wei’s SV correction is dynamic2𝑎𝑎 and therefore unique to any stage ofto Wei’s complete equation, the SV correction fac Referring to Wei’s complete equation, the SV correction fac the cardiac cycle. 1 − 0.465)1= 22.5230 𝑎𝑎 = 𝑆𝑆𝑆𝑆 − 𝜌𝜌𝐿𝐿2 (𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 − 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 ) 32 − (1.2)(4.5)2 (0.855 1𝐺𝐺 1 = 2.329 𝑎𝑎 = 𝑆𝑆𝑆𝑆 − 𝜌𝜌𝐿𝐿2 (𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 − 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 ) 32 − (1.2)(4.5)2 (0.855 = 22.5230 0.4294 = 2.329 � 0.465) �1− 𝐺𝐺𝛾𝛾𝑏𝑏𝑏𝑏− 0.4294 A. Henton and F. Konecny Transonic Scisense Technical Note + 0.465) = �- 1− � (𝐺𝐺 ) + 𝐺𝐺 𝑏𝑏 = −𝑆𝑆𝑆𝑆 · −32(0.855 42.2400 𝑏𝑏−𝐸𝐸𝐸𝐸 𝑏𝑏−𝐸𝐸𝐸𝐸 𝛾𝛾 Transonic Scisense Technical Note A. Henton and F. Konecny 2013 𝑏𝑏 = −𝑆𝑆𝑆𝑆 · (𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 + 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 ) −32(0.855 + 0.465) = Therefore, - 42.2400 the specific value ofMarch, March, blood2013 conductance at end-d 𝛼𝛼 0.2962 𝑐𝑐 = 𝑆𝑆𝑆𝑆 · 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 · 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 32(0.855 ∙ 0.465) = 12.7224Therefore, the specific value of blood conductance at end-d by +2.329 to correct for the inherent SV underestimation at 𝑐𝑐 = 𝑆𝑆𝑆𝑆 · 𝐺𝐺 · 𝐺𝐺𝑏𝑏−𝐸𝐸𝐸𝐸 32(0.855 ∙ 0.465) = 12.7224 by +2.329 to correct for the inherent SV underestimation a Data Point𝑏𝑏−𝐸𝐸𝐸𝐸 1 (End-Diastole): cycle. Data Point 1 (End-Diastole): cycle. Note: Wei’s equation Remembering that Wei’s SV correction factor is dynamic and therefore unique to anyalways uses the larger 2 2 −4(22.5230 ∙ 12.7224) −𝑏𝑏 ±√𝑏𝑏 −4𝑎𝑎𝑎𝑎 42.24 ±�−42.24 Remembering that Wei’s SV correction factor is dynamic and therefore unique to any andand 0.3770 γ = −𝑏𝑏 ±√𝑏𝑏2 −4𝑎𝑎𝑎𝑎 conductance = 1.4984 1.4984 0.3770 measurement blood (G during the ∙cardiac must calculate the positive solution for b2)−4(22.5230 42.24 ±�−42.24 12.7224) Datacycle, Point we 2 (End-Systole): 2(22.5230) 2𝑎𝑎 of measurement of blood conductance (G ) during the cardiac cycle, we must calculate the b γspecific = = 1.4984 and 0.3770 gamma (1.4984). DataBelow Pointis2 the (End-Systole): SV correction at any one point2(22.5230) in the cardiac cycle. specific SV correction specific SV2𝑎𝑎 correction at any one point in the cardiac cycle. Below is the specific SV correction Following same principle, below is the specific SV correc END-DIASTOLE END-SYSTOLE that would at ED:always uses the larger postive solution Note: Wei’soccur equation for γthe (1.4984) Following the same principle, below is the specific SV corre that would occur at ED: Note: Wei’s equation always uses the larger postive solution𝐺𝐺for γ (1.4984) 0.465 𝐺𝐺 0.855 �1 − 𝐺𝐺𝛾𝛾𝑏𝑏𝑏𝑏� �1 − 1.4984 �1 − 𝐺𝐺𝛾𝛾𝑏𝑏𝑏𝑏� �1 − 1.4984 0.465 � = 0.6897 0.855 � = 0.4294 �1 − 𝛾𝛾 � �1 − 1.4984� = 0.6897 � = 0.4294 �1 − � �1 − 𝛾𝛾 1.4984 Referring to Wei’scomplete complete equation,the the SV correction fac Referring the Wei’s equation, Referringto toWei’s Wei’scomplete completeequation, equation, the SV correctionReferring factor isto expressed as follows: Referring to Wei’s equation, the SV correction fac Referring to Wei’s equation, the SV correction factor is expressed follows: SV correction factorcomplete is expressed as follows: SV correction factor complete isas expressed as follows: 1 1 1 1 1𝐺𝐺𝑏𝑏 1𝐺𝐺 1 = 2.329 1 = 1.450 2.329 1.450 = 2.329 �1− 𝐺𝐺𝛾𝛾𝑏𝑏� 0.6897 = 1.450 �1− 𝐺𝐺𝛾𝛾𝑏𝑏𝑏𝑏� 0.4294 0.6897 0.4294 �1− � �1− � 𝛾𝛾 𝛾𝛾 Therefore, the specificwill measurement of blood conductance Therefore, the specific value of blood conductance at end-diastole (0.855mS) be multiplied Therefore, the specific measurement of blood conductance Therefore, the specific value of blood conductance at end-diastole (0.855mS) will be multiplied As from finalfor SV the correction factor values Wei’s equation multiplied by +1.450. by seen +2.329 to the correct inherent SV underestimation at that specific point of the cardiac multiplied by +1.450. by +2.329variable to correct for(2.329 the inherent SV underestimation at that specific point of the cardiac produces values and 1.450) depending on the cycle.point in the cardiac cycle as compared with Baan’s equation time cycle. which produces a single (and larger) value (3.376). Data Point 2 (End-Systole): Data Point 2 (End-Systole): Pressure-Volume The graph at right shows the resulting volume calculations by Baan’s and Wei’s equation vs. pressure for our sample data set. As we can see, when a common method of removing parallel/muscle conductance is used (in this case the phase measurement and admittance process), we can isolate the effect of the SV correction method unique to each equation. Baan’s equation uses a linear correction factor, alpha, to force the SV measurement to fit a reference SV measurement. Therefore, it does not account for the dynamic electrical field properties and resulting variable SV correction. Ultimately, this leads to an over-estimation of true volume (green PV loop). In comparison, Wei’s equation uses a dynamic correction factor defined by gamma and the real-time measurement of Gb. Gamma is a quadratic defined by the SV reference, blood resistivity, measurement field size, and specific measurement of Gb-ED and Gb-ES unique to the data set of interest. Ultimately this process derives a much more accurate SV correction throughout the cardiac cycle as it takes into account dynamic electrical properties. SV correction is therefore smaller at end-systole and a gradually increases as Gb approaches a maximum at end-diastole. A more accurate derivation of volume is shown using this correction process (blue PV loops). Pressue (mmHg) Comparison of Baan’s & Wei’s Final Calculated Volumes Volume (μL) Wei’s equation produces the blue PV loops while Baan’s equation produces the green PV loops with a larger volume. Transonic Systems Inc. is a global manufacturer of innovative biomedical measurement equipment. Founded in 1983, Transonic sells “gold standard” transit-time ultrasound flowmeters and monitors for surgical, hemodialysis, pediatric critical care, perfusion, interventional radiology and research applications. In addition, Transonic provides pressure and pressure volume systems, laser Doppler flowmeters and telemetry systems. www.transonic.com AMERICAS EUROPE ASIA/PACIFIC JAPAN Transonic Systems Inc. 34 Dutch Mill Rd Ithaca, NY 14850 U.S.A. Tel: +1 607-257-5300 Fax: +1 607-257-7256 [email protected] Transonic Europe B.V. Business Park Stein 205 6181 MB Elsloo The Netherlands Tel: +31 43-407-7200 Fax: +31 43-407-7201 [email protected] Transonic Asia Inc. 6F-3 No 5 Hangsiang Rd Dayuan, Taoyuan County 33747 Taiwan, R.O.C. Tel: +886 3399-5806 Fax: +886 3399-5805 [email protected] Transonic Japan Inc. KS Bldg 201, 735-4 Kita-Akitsu Tokorozawa Saitama 359-0038 Japan Tel: +81 04-2946-8541 Fax: +81 04-2946-8542 [email protected]
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