Jim, a 46-year-old male, had been told on several occasions that his blood pressure was at a borderline hypertensive level. Typically when he went to his physician, his systolic was between 132 and 140, while his diastolic measurement ranged from 88-92. Jim’s physician gave him instructions on diet, exercise and smoking cessation.
During a routine physical, Jim’s physician ordered an echocardiogram. This test indicated that the ejection fraction (EF) was 48%, however a slight thickening of the left ventricular myocardial walls was noted. Even though Jim’s blood pressure was 116/80 on this visit, Jim’s physician wanted further insight into myocardial functioning, and placed Jim on the IQ2™ noninvasive hemodynamic monitor.
Within two minutes Jim was connected to the IQ2™ monitor and his physician had access to hemodynamic information that added immeasurably to Jim’s clinical presentation. The following values presented on the monitor print out.
| Hemodynamic Parameter |
Normal Range |
Jim’s Value |
| Heart Rate |
60-90 bpm |
80 bpm |
| Cardiac Output |
4-8 l/min |
3.31 l/min |
| Cardiac Index |
2.5-4.0 l/min/m2 |
1.96 l/min/m2 |
| Stroke Volume |
60-120 ml/beat |
40 ml/beat |
| Zo – Base Impedance |
Men – 20-30 ohms
Women – 24-35 ohms |
25 ohms |
| SVR – Systemic Vascular Resistance |
800-1200 dyne sec/cm2 |
2100 dyne sec/cm2 |
| PEP – Pre Ejection Period |
0.05-0.12 sec |
0.149 sec |
| VET – Ventricular Ejection Time |
0.25-0.35 sec |
0.218 sec |
Jim was monitored for several minutes, but the clinical values illustrated that myocardial functioning was diminished, despite a normal blood pressure value, due to an elevated systemic vascular resistance, increasing afterload. Jim’s physician placed him on ACEi and asked him to return for repeat hemodynamic monitoring in two weeks.
Jim was monitored monthly at his physician's office with the IQ2™ noninvasive hemodynamic monitor. After six months of regular biking, eating a low fat low sodium diet, and following his prescribed medication regimen, Jim's hemodynamic profile significantly improved.
| Hemodynamic Parameter |
Normal Range |
Jim's Baseline Values |
Jim's 6-Month Values |
| Heart Rate |
60-90 bpm |
80 bpm |
72 |
| Cardiac Output |
4-8 l/min |
3.31 l/min |
5.52 l/min |
| Cardiac Index |
2.5-4.0 l/min/m2 |
1.96 l/min/m2 |
2.6 l/min2 |
| Stroke Volume |
60-120 ml/beat |
40 ml/beat |
68 ml/beat |
| Zo – Base Impedance |
Men – 20-30 ohms
Women – 24-35 ohms |
25 ohms |
24 ohms |
| SVR – Systemic Vascular Resistance |
800-1200 dyne sec/cm2 |
2100 dyne sec/cm2 |
1124 dyne sec/cm2 |
| PEP – Pre Ejection Period |
0.05-0.12 sec |
0.149 sec |
0.128 sec |
| VET – Ventricular Ejection Time |
0.25-0.35 sec |
0.218 sec |
0.29 sec |
Jim's blood pressure continues to remain within normal limits during physician office
visits. In addition he monitors his blood pressure daily at home and exhibits an average morning measurement of 112/66 mm/hg. Jim's six month echocardiogram also indicated that the left ventricular wall thickening had diminished slightly. He intends to follow a lifetime regimen of
exercise and healthy eating as well as remain on his medication. |
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