Document Detail


Cardiac output by transesophageal echocardiography using continuous-wave Doppler across the aortic valve.
MedLine Citation:
PMID:  8024133     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The use of transesophageal echocardiography for the determination of cardiac output (CO) has been limited to date. We assessed the capability of aortic continuous-wave Doppler transesophageal echocardiography to determine CO (DCO) in a transgastric long-axis imaging plane of the heart by comparing DCO to thermodilution CO (TCO). METHODS: DCO was determined in 63 consecutive patients undergoing cardiac surgery. Aortic valve area was obtained from the transverse short-axis view of the valve assuming a triangular shape for the valve orifice. Stroke volume was calculated as the product of velocity-time integral and aortic valve area: stroke volume = velocity-time integral x aortic valve area. DCO was calculated off-line, by multiplying stroke volume with heart rate: DCO = stroke volume x heart rate. RESULTS: The aortic valve orifice was easily imaged in all patients. Excellent-quality continuous-wave Doppler flow profiles were obtained in nearly all (62 of 63). A total of 109 DCO determinations were performed. Mean DCO was 4.35 +/- 1.18 l.min-1 (range 2.02-7.42 l.min-1), and mean TCO was 4.41 +/- 1.17 l.min-1 (range 2.24-8.94 l.min-1). Very high correlation and agreement were found between the two methods: DCO = 0.94 x TCO + 0.19, r = 0.94, SEE (standard error of the estimate) = 0.41 l.min-1; 95% confidence interval = 0.06 +/- 0.83 l.min-1. Relative changes from pre- to postbypass CO (delta) also showed a strong correlation (delta DCO = 0.93 x delta TCO + 5.4%, r = 0.82, SEE = 17.8%). For CO changes greater than 10%, Doppler was in accordance with thermodilution in 43 of 45 measurements. DCO repeatability coefficient was 0.51 l.min-1. CONCLUSIONS: Compared to thermodilution, continuous-wave Doppler measurements of blood flow velocity across the aortic valve in the transesophageal echocardiographic transgastric view allow accurate CO determination.
Authors:
P L Darmon; Z Hillel; A Mogtader; B Mindich; D Thys
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  80     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1994 Apr 
Date Detail:
Created Date:  1994-08-04     Completed Date:  1994-08-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  796-805; discussion 25A     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York 10025.
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MeSH Terms
Descriptor/Qualifier:
Aorta / ultrastructure
Aortic Valve / anatomy & histology,  ultrasonography*
Cardiac Output*
Echocardiography, Doppler / methods
Echocardiography, Transesophageal / methods*
Heart / anatomy & histology,  physiology
Humans
Models, Cardiovascular
Reproducibility of Results
Systole / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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