Measurements of systolic time intervals using a transoesophageal pulsed echo-Doppler

Measurement of systolic time intervals (STI), an index of left ventricular (LV) systolic function, is usually labour intensive and requires considerable expertise to perform accurately. We have evaluated the accuracy of an automated, continuous and non-invasive STI measurement technique using a descending aortic blood velocity Doppler signal obtained using a transoesophageal echo-Doppler system (TEDS) and an ECG signal. STI were measured in adult pigs using a transoesophageal probe (4 x 4 mm pulsed wave Doppler transducer, 5-MHz frequency and a 3 x 3 mm echo transducer, 10-MHz frequency) associated with an ECG recorder. Measurements were performed at baseline and after injection of esmolol and dobutamine. TEDS data were compared with those obtained by one-line recordings of the electrocardiogram and the central aortic arterial pressure wave. Similar mean values were observed for pre-ejection period (PEPI), LV ejection time (LVET) and PEP/LVET with the two methods. Agreement between the methods (Bland and Altman's test) was excellent with 95% confidence intervals for PEP, LVET and PEP/LVET of -7.17 to +1.37 ms, -12.64 to +0.24 ms and -0.033 to +0.028, respectively. We conclude that the combination of descending aorta blood velocity Doppler and ECG signal is an alternative technique for non-invasive and objective measurement of STI, allowing continuous monitoring of LV systolic function.