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Related Experiment Videos

Left ventricular performance indices by transesophageal Doppler.

D M Thys1, Z Hillel

  • 1Department of Anesthesiology, Mount Sinai School of Medicine, New York, New York 10029.

Anesthesiology
|November 1, 1988
PubMed
Summary

Esophageal Doppler monitoring of descending aortic blood flow effectively reflects left ventricular performance. This minimally invasive technique provides valuable data on cardiac function, correlating well with ascending aortic measurements.

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Area of Science:

  • Cardiology
  • Anesthesiology
  • Medical Devices

Background:

  • Left ventricular performance is typically assessed using ascending aortic blood flow velocity signals.
  • Esophageal Doppler is a minimally invasive method for monitoring cardiac function.

Purpose of the Study:

  • To evaluate if esophageal Doppler-derived blood flow velocity signals from the descending aorta can indicate changes in ventricular performance.
  • To compare descending aorta measurements with established ascending aorta metrics.

Main Methods:

  • Utilized a transesophageal continuous-wave Doppler transducer to acquire velocity signals from the descending aorta in 26 anesthetized patients undergoing myocardial revascularization.
  • Measured maximum blood flow velocity (Vm), maximum blood flow volume acceleration (Accv), and maximum linear blood flow acceleration (Acc).

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  • Administered halothane to assess its impact on measured parameters and used phenylephrine to counteract induced changes.

    • Main Results:

    • A strong correlation (r=0.91) was found between Accv in the ascending and descending aorta in a subset of patients.
    • Halothane administration did not alter Vm, Accv, or Acc in the descending aorta but decreased the product of mean arterial pressure and Acc (P-Acc) and systemic vascular resistance and Acc (R-Acc).
    • Phenylephrine reversed the decrease in R-Acc, while Vm, Accv, Acc, and P-Acc continued to decrease, indicating their sensitivity to ventricular performance changes.

    Conclusions:

    • Transesophageal Doppler assessment of descending aortic blood flow is feasible and provides reliable indices of left ventricular performance.
    • Descending aortic Accv correlates well with ascending aortic measurements.
    • Changes in P-Acc derived from descending aortic flow reflect alterations in left ventricular performance, validating the technique's utility.