An automated, indirect assessment of cardiac output during rest and exercise

The present study describes a modification of the equilibration CO2-rebreathing technique for determining cardiac output (Q), utilizing the Beckman Metabolic Measurement Cart (MMC) to provide partial automation of the procedures described by Jones et al. (Clinical Exercise Testing. Philadelphia, PA: Saunders, 1975). Q was determined in six normal healthy males to establish the reliability of the technique at rest, and during exercise at power outputs of 49 and 98 W, or 300 and 600 kpm/min. An additional 11 patients, who were symptomatic for coronary artery disease and scheduled for right and left heart catheterization, were used in validating these procedures against Q determined by the thermodilution method. The automated CO2-rebreathing procedure was found to be reliable at rest and during exercise, and demonstrated a direct linear relationship with VO2 (r = 0.90). Also, this procedure correlated (r = 0.87) with the thermodilution method during supine rest, and both methods were quite consistent between trials within the same subject. It was concluded that the CO2-rebreathing procedure used in this study, as interfaced with the Beckman MMC, provides reasonable estimates of Q, both in patients during supine rest, and in normal healthy subjects at rest and during low to moderate levels of exercise.