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Correlation Between RVOT VTI Measured via a Modified Subcostal View and LVOT VTI in Critically Ill Patients
Issac Cheong1,2, Matías Brizuela2,3, Francisco Marcelo Tamagnone2
1Department of Critical Care Medicine, Sanatorio de Los Arcos, Buenos Aires, Argentina.
Journal of Clinical Ultrasound : JCU
|May 28, 2026
Summary
Right ventricular outflow tract velocity-time integral (RVOT VTI) correlates with left ventricular outflow tract velocity-time integral (LVOT VTI) in critically ill patients. RVOT VTI may serve as a viable alternative when LVOT VTI measurement is challenging.
Area of Science:
- Critical Care Medicine
- Cardiovascular Physiology
- Diagnostic Imaging
Background:
- Transthoracic echocardiography is crucial for cardiac output assessment in critically ill patients.
- Left ventricular outflow tract velocity-time integral (LVOT VTI) is a standard measurement.
- Obtaining adequate apical views for LVOT VTI can be difficult in intensive care units.
Purpose of the Study:
- To evaluate the correlation between right ventricular outflow tract velocity-time integral (RVOT VTI) and LVOT VTI.
- To determine if RVOT VTI can identify patients with normal LVOT VTI values.
Main Methods:
- Post hoc analysis of a prospective diagnostic accuracy study.
- Included adult patients from mixed medical-surgical ICUs where both RVOT and LVOT Doppler measurements were feasible.
- RVOT VTI measured via modified subcostal approach; LVOT VTI from apical five-chamber view.
Main Results:
- Strong positive correlation found between RVOT VTI and LVOT VTI (Spearman r = 0.72, p < 0.0001).
- Bland-Altman analysis showed a mean bias of -4.3 cm.
- RVOT VTI > 14.6 cm predicted LVOT VTI ≥ 17 cm with 80.7% sensitivity and 100% specificity.
Conclusions:
- RVOT VTI from a modified subcostal view is a potential alternative for assessing cardiac output when LVOT VTI is not obtainable.
- RVOT VTI and LVOT VTI should not be used interchangeably.
- RVOT VTI can aid in identifying normal forward flow and monitoring hemodynamic changes at the bedside.
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