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[Non-invasive evaluation of cardiac output by Doppler echocardiography]
Insights
Doppler echocardiography (DEC) accurately measures cardiac output (CO) compared to invasive thermodilution. This non-invasive method shows promise for monitoring treatment effectiveness in heart conditions, with aortic lesions as a noted limitation.
Area of Science:
- Cardiology
- Medical Imaging
- Hemodynamics
Background:
- Cardiac output (CO) measurement is crucial for assessing cardiac function.
- Invasive methods like thermodilution are standard but carry risks.
- Non-invasive alternatives are sought for improved patient monitoring.
Purpose of the Study:
- To evaluate the accuracy of Doppler echocardiography (DEC) for measuring cardiac output (CO).
- To compare DEC measurements against invasive thermodilution (T).
- To assess DEC's utility in patients with various heart diseases.
Main Methods:
- Twenty-two patients with diverse cardiac conditions underwent both invasive CO determination via right heart catheterization with thermodilution (T) and non-invasive Doppler echocardiography (DEC).
- DEC calculated CO using the formula: CO = Integral Velocity (IV) × Aortic Root Cross-Section Area (S) × Heart Rate (HR).
- Integral velocity was derived from planimetric curves of flow areas.
Main Results:
- A strong correlation (r=0.74) was observed between DEC and T for CO measurement across all patients.
- Excluding one case with severe aortic atherosclerosis, the correlation improved significantly (r=0.86).
- DEC demonstrated high precision and accuracy in CO assessment.
Conclusions:
- Doppler echocardiography (DEC) is a valuable and precise method for cardiac output (CO) assessment.
- DEC can be effectively utilized for monitoring the efficacy of cardiac treatments.
- Significant aortic lesions represent a limitation for accurate DEC-based CO measurements.
Abstract:
In order to evaluate Doppler echocardiography (DEC) used for cardiac output (CO) measurement, 22 patients (7 with coronary heart disease, 6 with dilatation cardiomyopathy, 5 with primary pulmonary hypertension and 4 with rheumatic heart disease) were studied. In all patients, invasive CO determination was performed by right heart catheterization, using thermodilution (T). In DEC, CO was calculated as CO = IV.S.HR, where IV was integral velocity, estimated on the basis of flow areas under planimetric curves, S was aortic root cross-section area, and HR was heart rate. A close correlation was demonstrated between DEC and T results (r-0.74). Only in one case with severe aortic atherosclerosis was there a significant difference between the data. This case excluded, the correlation becomes even closer (r-0.86). It is concluded that: 1) DEC is a valuable and precise method of CO assessment, 2) DEC may be used to monitor treatment efficacy, and 3) its limitation is aortic lesions.