PMID- 37439804 OWN - NLM STAT- MEDLINE DCOM- 20240202 LR - 20240228 IS - 1615-6692 (Electronic) IS - 0340-9937 (Print) IS - 0340-9937 (Linking) VI - 49 IP - 1 DP - 2024 Feb TI - Accuracy of VO(2) estimation according to the widely used Krakau formula for the prediction of cardiac output. PG - 50-59 LID - 10.1007/s00059-023-05196-0 [doi] AB - BACKGROUND: Invasive cardiac output (CO) is measured with the thermodilution (TD) or the indirect Fick method (iFM) in right heart catheterization (RHC). The iFM estimates CO using approximation formulas for oxygen consumption ([Formula: see text]O(2)), but there are significant discrepancies (> 20%) between both methods. Although regularly applied, the formula proposed by Krakau has not been validated. We compared the CO discrepancies between the Krakau formula with the reference (TD) and three established formulas and investigated whether alterations assessed in cardiac magnetic resonance imaging (CMR) determined the extent of the deviations. METHODS: This retrospective study included 188 patients aged 63 +/- 14 years (30% women) receiving both CMR and RHC. The CO was measured with TD or with the iFM using the formulas by Krakau, LaFarge, Dehmer, and Bergstra for [Formula: see text]O2 estimation (iFM-K/-L/-D/-B). Percentage errors were calculated as twice the standard deviation of the difference between two CO methods divided by their means; a cut-off of < 30% was regarded as acceptable. The iFM and TD-derived CO ratio was built, and deviations > 20% were counted. Logistic regression analyses were performed to identify determinants of a deviation of > 20%. RESULTS: The TD-derived CO (5.5 +/- 1.7 L/min) was significantly different from all iFM (K: 4.8 +/- 1.6, L: 4.3 +/- 1.6; D: 4.8 +/- 1.5 L/min; B: 5.4 +/- 1.8 L/min all p < 0.05). The iFM-K-CO differed from all methods (p < 0.001) except iFM‑D (p = 0.19). Percentage errors between TD-CO and iFM-K/-L/-D/-B were all beyond the acceptance limit (44/45/44/43%), while percentage errors between iFM‑K and other iFM were all < 16%. None of the parameters measured in CMR was predictive of a discrepancy of > 20% between both methods. CONCLUSION: The Krakau formula was comparable to other iFM in estimating CO levels, but none showed satisfactory agreement with the TD method. Improved derivation cohorts for [Formula: see text]O(2) estimation are needed that better reflect today's patients undergoing RHC. CI - (c) 2023. The Author(s). FAU - Reiter, Theresa AU - Reiter T AD - Department of Internal Medicine I, Cardiology Division, University Hospital Wurzburg, Oberdurrbacherstr. 6, 97080, Wurzburg, Germany. FAU - Kerzner, Julia AU - Kerzner J AD - Department of Internal Medicine I, Cardiology Division, University Hospital Wurzburg, Oberdurrbacherstr. 6, 97080, Wurzburg, Germany. FAU - Fette, Georg AU - Fette G AD - Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Wurzburg, Am Schwarzen Berg 26, 97078, Wurzburg, Germany. AD - Chair of Computer Science VI, University of Wurzburg, 97074, Wurzburg, Germany. FAU - Frantz, Stefan AU - Frantz S AD - Department of Internal Medicine I, Cardiology Division, University Hospital Wurzburg, Oberdurrbacherstr. 6, 97080, Wurzburg, Germany. AD - Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Wurzburg, Am Schwarzen Berg 26, 97078, Wurzburg, Germany. FAU - Voelker, Wolfram AU - Voelker W AD - Department of Internal Medicine I, Cardiology Division, University Hospital Wurzburg, Oberdurrbacherstr. 6, 97080, Wurzburg, Germany. FAU - Ertl, Georg AU - Ertl G AD - Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Wurzburg, Am Schwarzen Berg 26, 97078, Wurzburg, Germany. FAU - Bauer, Wolfgang AU - Bauer W AD - Department of Internal Medicine I, Cardiology Division, University Hospital Wurzburg, Oberdurrbacherstr. 6, 97080, Wurzburg, Germany. FAU - Morbach, Caroline AU - Morbach C AD - Department of Internal Medicine I, Cardiology Division, University Hospital Wurzburg, Oberdurrbacherstr. 6, 97080, Wurzburg, Germany. AD - Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Wurzburg, Am Schwarzen Berg 26, 97078, Wurzburg, Germany. FAU - Stork, Stefan AU - Stork S AD - Department of Internal Medicine I, Cardiology Division, University Hospital Wurzburg, Oberdurrbacherstr. 6, 97080, Wurzburg, Germany. AD - Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Wurzburg, Am Schwarzen Berg 26, 97078, Wurzburg, Germany. FAU - Guder, Gulmisal AU - Guder G AUID- ORCID: 0000-0002-5598-5359 AD - Department of Internal Medicine I, Cardiology Division, University Hospital Wurzburg, Oberdurrbacherstr. 6, 97080, Wurzburg, Germany. gueder_g@ukw.de. LA - eng GR - 01EO1504/Bundesministerium fur Bildung und Forschung/ GR - Open Access Publication Fund/Julius-Maximilians-Universitat Wurzburg/ PT - Journal Article TT - Genauigkeit der VO(2)-Schatzung nach der weitverbreiteten Krakau-Formel zur Pradiktion der kardialen Pumpleistung. DEP - 20230713 PL - Germany TA - Herz JT - Herz JID - 7801231 SB - IM MH - Humans MH - Female MH - Male MH - Retrospective Studies MH - Cardiac Output MH - *Cardiac Catheterization MH - *Thermodilution MH - Oxygen Consumption PMC - PMC10830659 OTO - NOTNLM OT - Cardiac output OT - Indirect Fick method OT - O2 approximation OT - Thermodilution COIS- T. Reiter, J. Kerzner, G. Fette, S. Frantz, W. Voelker, G. Ertl, W. Bauer, C. Morbach, S. Stork and G. Guder declare that they have no competing interests. EDAT- 2023/07/13 12:31 MHDA- 2024/02/02 06:42 PMCR- 2023/07/13 CRDT- 2023/07/13 11:05 PHST- 2023/03/14 00:00 [received] PHST- 2023/06/01 00:00 [accepted] PHST- 2023/05/21 00:00 [revised] PHST- 2024/02/02 06:42 [medline] PHST- 2023/07/13 12:31 [pubmed] PHST- 2023/07/13 11:05 [entrez] PHST- 2023/07/13 00:00 [pmc-release] AID - 10.1007/s00059-023-05196-0 [pii] AID - 5196 [pii] AID - 10.1007/s00059-023-05196-0 [doi] PST - ppublish SO - Herz. 2024 Feb;49(1):50-59. doi: 10.1007/s00059-023-05196-0. Epub 2023 Jul 13.