The American journal of cardiology
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Comparative Study
Validity of cardiac output measurement by computer-averaged impedance cardiography, and comparison with simultaneous thermodilution determinations.
The accuracy and reproducibility of noninvasive cardiac output determinations by computer-averaged impedance cardiography were compared with those of simultaneously performed thermodilution cardiac output. In all, 43 patients (14 men and 29 women = 201 pairs) were studied by simultaneously performed impedance and thermal determinations. Individual impedance values correlated with paired thermodilution determinations (r = 0.75; p less than 0.0001). ⋯ Mean impedance output was 4.5 +/- 1.27 liter/min Reproducibility was comparable for impedance (0.0059 +/- 0.639) and thermodilution cardiac output (0.023 +/- 0.556). There was high agreement between methods by plot of the difference against mean of the 2 methods. Impedance cardiac output values agree and correlate highly with quality-controlled thermodilution outputs across a wide range of clinical conditions and hemodynamic values.
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Spinal cord stimulation (SCS) can relieve symptoms in patients with severe angina pectoris refractory to conventional medical or surgical therapy. This symptomatic improvement may result from decreased myocardial ischemia. To test this hypothesis, positron emission tomography (PET) and potassium-38 as a flow tracer were used in 8 patients for the quantitative evaluation of regional myocardial perfusion at rest and after exercise, before and during SCS. ⋯ However, the magnitude and duration of ST-segment depression decreased during treatment with SCS. Anginal pain occurred in all patients during control exercise, but was attenuated in all but one with SCS. These results indicate that SCS improves exercise-induced angina and electrocardiographic signs of ischemia but this influence does not appear to be mediated by changes in regional myocardial perfusion.