Abstract
Measurement of cardiac function is vital for the health of pediatric patients with heart disease. Standard tools to measure function including echocardiogram and magnetic residence imaging are time intensive, costly, and have limited accessibility. The Vivio is a novel, non-invasive, handheld device that screens for cardiac dysfunction by analyzing intrinsic frequencies (IF) ω1 and ω2 of carotid artery waveforms. Prior studies demonstrated that left ventricular ejection fraction can be derived from IFs in adults. This study 1) studies whether the Vivio can capture carotid arterial pulse waveform data in children ages 0-19 years old; 2) tests the performance of two sensor head geometries, one larger and smaller than the standard size used in adults, designed for the pediatric population; 3) compares the IFs between pediatric age groups and adults with normal function. The Vivio successfully measured a carotid artery waveform in all children over 5 years old and 28% of children under the age of five. The small head did not accurately measure a waveform in any age group. One-way analysis of variance (ANOVA) demonstrated a difference in the IF ω1 between the adult and pediatric cohorts (F = 7.3, Prob>F = 0.0001). Post host analysis demonstrated a difference between the adult cohort (ω1 = 99 +/- 5 bpm) and the cohorts ages 0-4 (ω1 = 111 +/- 2 bpm; p = 0.0006) and 15-19 years old (ω1 = 105 +/-5 bpm; p = 0.02). One-way ANOVA demonstrated a difference in the IF ω2 between the adult and pediatric cohorts (F = 4.8, Prob>F = 0.003), specifically between the adult (ω2 = 81 +/- 13 bpm) and age 0-4 cohorts (ω2 = 48 +/- 8 bpm; p = 0.002). These results suggest that the Vivio can be used to capture carotid pulse waveform data in pediatric populations and that the data produced can be used to measure intrinsic frequencies.
Highlights
Cardiovascular function is central to the health of pediatric patients with congenital and acquired heart disease, but the ability to accurately assess cardiac hemodynamics rapidly in a non-invasive manner is limited [1]
This study demonstrates the feasibility of non-invasive measurement of carotid artery waveforms and evaluating intrinsic frequency (IF) (ω1 and ω2) in children 5 years of age and older with normal cardiovascular anatomy and left ventricular (LV) function using a handheld wireless device, the Vivio
We showed the difference between IFs values (ω1 and ω2) of pediatric population and of adults with structurally normal hearts and normal LV function
Summary
Cardiovascular function is central to the health of pediatric patients with congenital and acquired heart disease, but the ability to accurately assess cardiac hemodynamics rapidly in a non-invasive manner is limited [1]. LV function is typically assessed by linear (M-mode) or two-dimensional echocardiographic indices such as the modified Simpson method or 5/6 area-length method [3,4,5]. Technical issues such as inadequate image quality and measurement variability based on assumptions that a single plane accurately represents a normally shaped ellipsoidal LV limit these methods [6,7,8]. There remains a need for a non-invasive, inexpensive, and easy to use device for the diagnosis and monitoring of cardiovascular health in the pediatric population
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