Reliability of Doppler echocardiographic stroke volume measurement

To evaluate the accuracy and utility of the echocardiographic Doppler method of determining the stroke volume, the stroke volume was measured in 64 instances in 15 patients and compared to the simultaneous thermodilution stroke volume determinations. Stroke volume, varied by atrial pacing at various heart rates, was calculated noninvasively by the product of the cross-sectional area of the aortic orifice determined by echocardiography and the flow velocity integral measured by continuous wave Doppler. While the cardiac output was increased moderately by atrial pacing, the stroke volume was decreased in relation to the increase in the heart rate. The stroke volume calculated by the echo-Doppler method exhibited a significant linear relationship to the stroke volume determined by thermodilution (r = 0.84) and to the cardiac output (r = 0.75, p less than 0.01). Inter-observer and intra-observer variability was 7 +/- 4% and 5 +/- 4%, respectively. The noninvasive echo-Doppler method of estimating the stroke volume is concluded to be accurate, specifically, to be comparable to the values obtained by thermodilution and with a low inter- and intra-observer variability.