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Circulation, Vol 70, 425-431, Copyright © 1984 by American Heart Association
JF Lewis, LC Kuo, JG Nelson, MC Limacher and MA Quinones
Two methods of measuring stroke volume and cardiac output with pulsed
Doppler two-dimensional echocardiography were developed and validated
against the thermodilution technique in 39 patients, 33 of which were in an
intensive care unit. With the use of the apical four-chamber view, a mitral
inflow method combined the velocity of left ventricular inflow at the
mitral anulus with the cross-sectional area of the anulus calculated from
its diameter at middiastole (area = pi r2). From the apical five-chamber
view a left ventricular outflow method combined the velocity of left
ventricular outflow with the cross-sectional area of the aortic anulus
calculated from its diameter during early systole (parasternal long-axis
view). Measurements with the mitral inflow and left ventricular outflow
methods were obtained in 35 of 39 (90%) and 39 of 39 (100%) patients,
respectively. Validation of the mitral method excluded patients with mitral
regurgitation (n = 11) and validation of the left ventricular outflow
method excluded those with aortic regurgitation (n = 4). Good correlations
were observed between thermodilution and Doppler measurements of stroke
volume and cardiac output for both the mitral anulus method (R = .96 and
.87, respectively) and the left ventricular outflow method (R = .95 and
.91, respectively). The results of the two methods correlated well with
each other in patients without regurgitant valve lesions. A greater
interobserver variability was observed with the mitral anulus method, which
was related solely to greater variability in measuring the annular
diameter.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Pulsed Doppler echocardiographic determination of stroke volume and cardiac output: clinical validation of two new methods using the apical window
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