PMID- 7860918
OWN - NLM
STAT- MEDLINE
DCOM- 19950323
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 25
IP  - 3
DP  - 1995 Mar 1
TI  - Cardiac index quantification by Doppler ultrasound in patients without left 
      ventricular outflow tract abnormalities.
PG  - 710-6
AB  - OBJECTIVES: We attempted to ascertain whether cardiac index can be directly 
      estimated from Doppler mean velocity. BACKGROUND: Although diverse Doppler 
      echocardiographic methods have been described for cardiac output quantification, 
      they are not widely used in clinical practice. Cross-sectional area measurement 
      has been identified as the main source of error in flow volume quantification. 
      METHODS: A three-phase study by Doppler echocardiography was conducted in 306 
      patients. In phase I, the normal mean velocity ratio of the left and right 
      ventricular outflow tracts was established in 170 normal subjects. In phase II, 
      cardiac index, calculated as the product of aortic annular area index by mean 
      velocity (conventional method), and mean velocity determined in the left 
      ventricular outflow tract and ascending aorta by pulsed and continuous wave 
      Doppler, respectively, were correlated with thermodilution cardiac index in 66 
      patients. In phase III, the accuracy of the regression equations obtained was 
      prospectively assessed in an additional 70 patients. RESULTS: The normal 
      left/right ventricular outflow tract mean velocity ratio by pulsed wave Doppler 
      was 1.1 +/- 0.1. Cardiac index (CI) calculated by the conventional method and 
      thermodilution (TD) showed acceptable correlation (r = 0.90, CITD = 1.20 CIPWD + 
      357; r = 0.86, CITD = 0.90 CICWD + 262) for pulsed (PWD) and continuous wave 
      (CWD) Doppler, respectively, but with systematic underestimation (-28 +/- 13%, p 
      < 0.01) by pulsed wave Doppler. Mean velocity (MV) showed excellent correlation 
      with the thermodilution cardiac index (r = 0.97, CITD = 172 MVPWD - 172; r = 
      0.93, CITD = 129 MVCWD - 255). When these regression equations were prospectively 
      applied, better agreement with the thermodilution cardiac index was obtained by 
      pulsed wave Doppler directly from mean velocity (SD 240 ml/min per m2) than when 
      aortic annular area was considered in the calculation (SD 428 ml/min per m2). 
      Similar results were obtained by continuous wave Doppler (SD 433 vs. 599 ml/min 
      per m2) but with less accuracy. CONCLUSIONS: Left ventricular outflow tract mean 
      velocity determined by pulsed wave Doppler permits easy, accurate cardiac index 
      quantification in the absence of left ventricular outflow abnormalities. The 
      simplicity of this method enhances its clinical applicability in noninvasive 
      monitoring of cardiac index.
FAU - Evangelista, A
AU  - Evangelista A
AD  - Servei de Cardiologia, Hospital General Universitari Vall d'Hebron, Barcelona, 
      Spain.
FAU - Garcia-Dorado, D
AU  - Garcia-Dorado D
FAU - Garcia del Castillo, H
AU  - Garcia del Castillo H
FAU - Gonzalez-Alujas, T
AU  - Gonzalez-Alujas T
FAU - Soler-Soler, J
AU  - Soler-Soler J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Output/physiology
MH  - Child
MH  - *Echocardiography, Doppler
MH  - Female
MH  - Heart/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Thermodilution
MH  - Ventricular Function, Left/*physiology
EDAT- 1995/03/01 00:00
MHDA- 1995/03/01 00:01
CRDT- 1995/03/01 00:00
PHST- 1995/03/01 00:00 [pubmed]
PHST- 1995/03/01 00:01 [medline]
PHST- 1995/03/01 00:00 [entrez]
AID - 073510979400456Z [pii]
AID - 10.1016/0735-1097(94)00456-z [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 1995 Mar 1;25(3):710-6. doi: 10.1016/0735-1097(94)00456-z.