PMID- 9054753
OWN - NLM
STAT- MEDLINE
DCOM- 19970403
LR  - 20190623
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 95
IP  - 4
DP  - 1997 Feb 18
TI  - Automated cardiac output measurement by spatiotemporal integration of color 
      Doppler data. In vitro and clinical validation.
PG  - 932-9
AB  - BACKGROUND: A new Doppler echocardiographic technique has been developed for 
      automated cardiac output measurement (ACOM) that assumes neither a flat flow 
      profile nor collinearity with the scan line, but clinical validation of this 
      method is lacking. METHODS AND RESULTS: In 165 subjects (50 intensive care 
      patients, 10 dobutamine echocardiography patients, and 105 normal volunteers; 
      age, 49.4 +/- 19.3 years; 92 men), ACOM was performed in the left ventricular 
      outflow tract (LVOT), with the color baseline shifted to avoid aliasing. ACOM was 
      also tested in a pulsatile in vitro model. Stroke volume was calculated by double 
      integration of Doppler signals in space (across the LVOT) and in time (through 
      the systolic period), assuming hemiaxial symmetry: integral of integral of pi r 
      v(r,t) dr dt, where v(r,t) is the velocity at a distance r from the center of the 
      LVOT at time t during systole. Stroke volume from ACOM was compared with 
      thermodilution (TD), aortic valve pulsed-wave Doppler (PWAO), and left 
      ventricular echocardiographic (two-dimensional [2D]) methods. There was good 
      correlation between ACOM and PWAO (r = .93). TD (r = .86), and 2D (r = .74), with 
      close agreement seen. ACOM had higher correlation and agreement with TD than did 
      either PWAO (P < .02) or 2D (P < .01). ACOM was also able to track accurately the 
      changes in cardiac output with dobutamine infusion in comparison with PWAO (r = 
      .94). In vitro assessment demonstrated excellent correlation (r = .98, y = 1.0x + 
      1.94) with little impact of pulse repetition frequency or misalignment up to 30 
      degrees. Gain dependency was noted but could be optimized by visual inspection of 
      the color image. CONCLUSIONS: Automatic integration of numerical data within 
      color Doppler flow fields is a feasible new method for quantifying flow. It is 
      simpler and faster, requires fewer assumptions, and uses only one apical view. 
      ACOM is a promising new approach to echocardiographic quantification that 
      deserves further study and refinement.
FAU - Sun, J P
AU  - Sun JP
AD  - Department of Cardiology, Cleveland (Ohio) Clinic Foundation 44195, USA.
FAU - Pu, M
AU  - Pu M
FAU - Fouad, F M
AU  - Fouad FM
FAU - Christian, R
AU  - Christian R
FAU - Stewart, W J
AU  - Stewart WJ
FAU - Thomas, J D
AU  - Thomas JD
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Adrenergic beta-Agonists)
RN  - 3S12J47372 (Dobutamine)
SB  - IM
MH  - Adolescent
MH  - Adrenergic beta-Agonists
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Algorithms
MH  - Automation
MH  - *Cardiac Output/drug effects
MH  - Coronary Circulation
MH  - Critical Illness
MH  - Dobutamine
MH  - *Echocardiography, Doppler, Color
MH  - Female
MH  - Heart Diseases/*diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Reference Values
MH  - Regression Analysis
MH  - Reproducibility of Results
MH  - Stroke Volume
MH  - Time Factors
OTO - NASA
OT  - Non-programmatic
EDAT- 1997/02/18 00:00
MHDA- 1997/02/18 00:01
CRDT- 1997/02/18 00:00
PHST- 1997/02/18 00:00 [pubmed]
PHST- 1997/02/18 00:01 [medline]
PHST- 1997/02/18 00:00 [entrez]
AID - 10.1161/01.cir.95.4.932 [doi]
PST - ppublish
SO  - Circulation. 1997 Feb 18;95(4):932-9. doi: 10.1161/01.cir.95.4.932.