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Technical Brief

Time Course Response of the Heart and Circulatory System to Active Postural Changes

[+] Author and Article Information
Jo P. Pauls

School of Medicine,
The University of Queensland,
St Lucia, QLD 4067, Australia;
Innovative Cardiovascular Engineering
and Technology Laboratory,
Critical Care Research Group,
The Prince Charles Hospital,
Rode Road,
Chermside, QLD 4032, Australia;
School of Engineering,
Griffith University,
Southport, QLD 4215, Australia
e-mail: j.pauls@uq.edu.au

Llion A. Roberts

School of Allied Health Sciences,
Griffith University,
Southport, QLD 4215, Australia;
Menzies Health Institute Queensland,
Griffith University,
Southport, QLD 4215, Australia

Tom Burgess

Innovative Cardiovascular Engineering
and Technology Laboratory,
Critical Care Research Group,
The Prince Charles Hospital,
Rode Road,
Chermside, QLD 4032, Australia

John F. Fraser

School of Medicine,
The University of Queensland,
St Lucia, QLD 4067, Australia;
Innovative Cardiovascular Engineering
and Technology Laboratory,
Critical Care Research Group,
The Prince Charles Hospital,
Rode Road,
Chermside, QLD 4032, Australia

Shaun D. Gregory

School of Medicine,
The University of Queensland,
St Lucia, QLD 4067, Australia;
Innovative Cardiovascular Engineering
and Technology Laboratory,
Critical Care Research Group,
The Prince Charles Hospital,
Rode Road,
Chermside, QLD 4032, Australia;
School of Engineering,
Griffith University,
Southport, QLD 4215, Australia

Geoff Tansley

Innovative Cardiovascular Engineering
and Technology Laboratory,
Critical Care Research Group,
The Prince Charles Hospital,
Rode Road,
Chermside, QLD 4032, Australia;
School of Engineering,
Griffith University,
Southport, QLD 4215, Australia

1Corresponding author.

Manuscript received April 3, 2017; final manuscript received October 26, 2017; published online January 17, 2018. Assoc. Editor: C. Alberto Figueroa.

J Biomech Eng 140(3), 034501 (Jan 17, 2018) (4 pages) Paper No: BIO-17-1139; doi: 10.1115/1.4038429 History: Received April 03, 2017; Revised October 26, 2017

Rotary blood pumps (RBPs) used for mechanical circulatory support of heart failure patients cannot passively change pump flow sufficiently in response to frequent variations in preload induced by active postural changes. A physiological control system that mimics the response of the healthy heart is needed to adjust pump flow according to patient demand. Thus, baseline data are required on how the healthy heart and circulatory system (i.e., heart rate (HR) and cardiac output (CO)) respond. This study investigated the response times of the healthy heart during active postural changes (supine-standing-supine) in 50 healthy subjects (27 male/23 female). Early response times (te) and settling times (ts) were calculated for HR and CO from data continuously collected with impedance cardiography. The initial circulatory response of HR and CO resulted in te of 9.0–11.7 s when standing up and te of 4.7–5.7 s when lying back down. Heart rate and CO settled in ts of 50.0–53.6 s and 46.3–58.2 s when standing up and lying down, respectively. In conclusion, when compared to active stand up, HR and CO responded significant faster initially when subjects were lying down (p < 0.05); there were no significant differences in response times between male and female subjects. These data will be used during evaluation of physiological control systems for RBPs, which may improve patient outcomes for end-stage heart failure patients.

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Figures

Grahic Jump Location
Fig. 1

(a) Early response time te and settling time ts during active change in posture. te was defined as the time from start of the change in posture until HR, CO and SV reached a maximum peak. The time required for the circulatory system to settle HR, CO, and SV within a range of 5% of the new settled value following the change in posture was defined as ts. (b) Example traces for HR, CO and SV versus time during an active postural change.

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