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Evaluation of a new transcardiac conductance method for continuous on-line measurement of left ventricular volume
P Steendijk1, J W Lardenoye, E T van der Velde
1Leiden University Medical Centre, Department of Cardiology, The Netherlands.
Objective:
To evaluate a new, less invasive, conductance method to measure continuous on-line left ventricular volume. End-systolic and end-diastolic volumes obtained with this transcardiac conductance method were compared with simultaneous measurements using the conventional intracardiac conductance catheter.
Design:
Controlled animal study.
Setting:
Research laboratory in a university hospital.
Subjects:
Six sheep.
Interventions:
Anesthetized sheep were instrumented and inotropic condition was varied by beta-receptor stimulation (5 microg/kg/min of dobutamine) and beta-receptor blockade (1 mg/kg of propranolol). In each condition (control, dobutamine, repeat control, propranolol), ventricular volume was varied over a wide range by gradual preload reduction using a vena caval balloon catheter.
Measurements And Main Results:
We compared the two methods by performing linear regression analysis on simultaneous end-systolic and end-diastolic volumes obtained during gradual caval occlusions. We statistically analyzed the intercepts, slopes, and correlation coefficients of the regression equations relating the transcardiac and conductance catheter measurements to determine the effects of interanimal variability, inotropic condition, and cardiac phase on the relationship between the two methods. The results show an excellent linear correlation between the two methods (mean intercept, -1.82+/-1.24 mL; mean slope, 0.787+/-0.024 and r2 = .94). Both slope and intercept of the relationship between the two methods show a significant interanimal and cardiac phase related variability but no significant dependence on inotropic condition.
Conclusions:
The significant interanimal variability indicates that the new method requires individual calibration in each subject. However, the small variability of the regression coefficients with changes in condition indicates that after initial calibration, end-systolic and end-diastolic volume can be followed accurately even in the presence of large changes in volume and inotropic state. This new method may facilitate quantitative continuous assessment of cardiac function in clinical practice, for example, in the intensive care unit.