Document Detail


Stroke volume determination using transcardiopulmonary thermodilution and arterial pulse contour analysis in severe aortic valve disease.
MedLine Citation:
PMID:  23287875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Transcardiopulmonary thermodilution (TPTD, SVTD) as well as calibrated (SVPC CAL) and uncalibrated (SVPC UNCAL) arterial pulse contour analysis (PC) are increasingly promoted as less-invasive technologies to measure stroke volume (SV) but their reliability in aortic valve disease was unknown. The objective of this prospective study was to investigate the validity of three less-invasive techniques to assess SV in conditions involving aortic stenosis (AS) and valvuloplasty-induced aortic insufficiency (AI) compared with transesophageal echocardiography.
METHODS: In 18 patients undergoing transcatheter aortic valve implantation, SVTD and SVPC CAL were determined using a central pressure signal via the brachial artery and SVPC UNCAL using a peripheral radial signal.
RESULTS: In aortic valve dysfunction TPTD achieved adequate reproducibility (concordance correlation coefficient (CCC): AS 0.84; AI 0.82) and agreement (percentage error (PE): AS 26.3 %; AI 26.2 %) with the reference technique. In severe AS, SVPC CAL (PE 25.7 %; CCC 0.85) but not SVPC UNCAL (PE 50.4 %; CCC 0.38) was reliable. Neither calibrated nor uncalibrated PC (SVPC CAL: PE 51.5 %; CCC 0.49; SVPC UNCAL: PE 61.9 %; CCC 0.22) was valid in AI. Trending ability to hemodynamic changes, quantified by the ΔSV vector and the angle θ, was acceptable for each measurement modality.
CONCLUSIONS: Transcardiopulmonary thermodilution is valid in aortic valve dysfunction. Calibration of PC substantially improves reliability in aortic valve disease. Calibrated PC is valid in severe AS. Valvuloplasty-induced AI seriously confounds PC measurements. In uncalibrated PC approaches, the relative SV trend is superior to single absolute values.
Authors:
Martin Petzoldt; Carsten Riedel; Jan Braeunig; Sebastian Haas; Matthias S Goepfert; Hendrik Treede; Stephan Baldus; Alwin E Goetz; Daniel A Reuter
Related Documents :
19022025 - True aneurysmal dilatation of a contegra conduit after right ventricular outflow tract ...
18199505 - Propionibacterium acnes: a rare cause of late prosthetic valve endocarditis and aortic ...
2347125 - The relationship between new cardiac conduction defects and extension of valve infectio...
2133835 - Technique of implantation of the medtronic-hall valve and other modern tilting-disc pro...
12791515 - Endothelium-dependent relaxation to poly-l-arginine in canine coronary arteries.
6525305 - The accessory middle cerebral artery (amca). diagnostic and therapeutic consequences.
Publication Detail:
Type:  Journal Article     Date:  2013-01-04
Journal Detail:
Title:  Intensive care medicine     Volume:  39     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-26     Completed Date:  2013-09-26     Revised Date:  2014-06-10    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  601-11     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Aortic Valve / physiopathology,  surgery
Cardiac Output / physiology*
Female
Germany
Heart Defects, Congenital / diagnosis,  physiopathology,  surgery*
Heart Valve Diseases / diagnosis,  physiopathology,  surgery*
Heart Valve Prosthesis Implantation*
Humans
Male
Prospective Studies
Pulse
Stroke Volume / physiology
Thermodilution / methods
Comments/Corrections
Comment In:
Intensive Care Med. 2013 Apr;39(4):787-9   [PMID:  23287877 ]
Intensive Care Med. 2014 May;40(5):767   [PMID:  24664153 ]

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


Previous Document:  The impact of early goal-directed fluid management on survival in an experimental model of severe ac...
Next Document:  A pilot study on safety and clinical utility of a single-use 72-hour indwelling transesophageal echo...