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A modified subcostal view: a novel method for measuring the LVOT VTI
Issac Cheong1,2, Victoria Otero Castro3, Raúl Alejandro Gómez3
1Department of Critical Care Medicine, Intensive Care Unit, CABA, Sanatorio De los Arcos, Juan B. Justo 909, Buenos Aires, Argentina. issac_cheong@hotmail.com.
Journal of Ultrasound
|April 22, 2022
Summary
A modified subcostal echocardiography view enables accurate measurement of the left ventricular outflow tract velocity time integral (LVOT VTI) in critically ill patients. This technique provides a reliable alternative when the standard apical view is challenging to obtain.
Area of Science:
- Cardiovascular Imaging
- Critical Care Medicine
- Echocardiography
Background:
- Left ventricular outflow tract velocity time integral (LVOT VTI) measured via echocardiography is a stroke volume surrogate.
- Obtaining optimal apical views for LVOT VTI assessment is difficult in critically ill patients.
- Standard subcostal views are inadequate for reliable LVOT VTI estimation due to suboptimal Doppler alignment.
Purpose of the Study:
- To introduce and validate a novel modified subcostal echocardiographic view for LVOT VTI measurement.
- To assess the feasibility and accuracy of this modified subcostal view in critically ill patients.
Main Methods:
- A single-centre, retrospective, observational study was conducted.
- Adult ICU patients (June 2020-January 2022) with echocardiography measurements in both apical and modified subcostal views were included.
- LVOT VTI was measured using Doppler in both views.
Main Results:
- Thirty patients were analyzed.
- Bland-Altman analysis showed a bias of 0.8 and 23% error between apical and modified subcostal VTI measurements.
- A strong correlation (R=0.98) was observed between the two measurement methods.
Conclusions:
- The modified subcostal view provides a reliable method for measuring LVOT VTI.
- This technique is a valuable alternative for assessing LVOT VTI when apical views are not feasible in critically ill patients.
