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Comparative evaluation of thermodilution and gated blood pool method for determination of right ventricular ejection
S M Perings1, C Perings, M Kelm
1Department of Medicine, Division of Cardiology, Pulmonary Disease and Angiology, Heinrich Heine University Düsseldorf, Germany. perings@uni-duesseldorf.de
Background:
Since the development of a Swan-Ganz thermodilution ejection fraction catheter several studies have been published which compare this technique for obtaining right ventricular ejection fraction (RVEF(TD)) with alternative methods. However, the reliability of RVEF(TD) measurements under exercise conditions remains undetermined. Therefore, the aim of the present study was a comparative evaluation of RVEF(TD) with the established gated blood pool method (RVEF(GBP)) under exercise conditions.
Methods And Results:
Twenty-two patients with different cardiac diseases underwent right heart catheterization, including RVEF(TD) and simultaneous RVEF(GBP) determination at rest and during supine bicycle exercise. Linear regression analysis showed a significant correlation between RVEF(TD) and RVEF(GBP) at rest (r = 0.73, p < or = 0.0005) and during exercise (r = 0.74, p < or = 0.0005). A Wilcoxon analysis showed a high probability of agreement of RVEF(TD) and RVEF(GBP) at rest and exercise (level of significance for error of the 0 hypothesis of 95.9/73.3%).
Conclusion:
The thermodilution ejection fraction catheter provides a useful device for reliable, repetitive and safe RVEF measurements, not only at rest but also under exercise conditions. This seems to be clinically important, because by it means RVEF, as a sensitive parameter of primary or secondary right ventricular dysfunction, can be determined in the course of standard right heart catheterization.