Thermodilution measures of right ventricular ejection fraction and volumes in heart transplant recipients: a comparison with radionuclide angiography.
A reliable, convenient measure of right ventricular ejection fraction may be a useful adjunct to evaluate cardiac allograft rejection. The purpose of this investigation was to compare two measures of right ventricular ejection fraction: (1) radionuclide angiography with the first-pass technique and (2) thermodilution with a balloon flotation catheter. The study was performed in 26 heart transplant recipients; hemodynamics, thermodilution cardiac output, and right ventricular ejection fraction were measured. First pass radionuclide angiography was performed either simultaneously (n = 11) or within 4 hours (n = 15) of the thermodilution study. Mean thermodilution right ventricular ejection fraction was 39% +/- 8%, and radionuclide angiography ejection fraction was 47% +/- 9%, which represents a highly significant difference (p < 0.001) in techniques. Linear regression showed no correlation between the two techniques (r = 0.3; p = NS). No differences in results were observed in those studied simultaneously versus less than 4 hours. We conclude that the thermodilution technique underestimates right ventricular ejection fraction in heart transplant recipients and that its usefulness as a tool to screen for systolic dysfunction related to rejection is limited.
Starling
R C
RC
Department of Internal Medicine, Ohio State University, Columbus 43210.
Binkley
P F
PF
Haas
G J
GJ
Hatton
P S
PS
Wooding-Scott
M
M
D006328:Cardiac Catheterization; D005260:Female; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013670:Sodium Pertechnetate Tc 99m; D013318:Stroke Volume / Q000502:physiology*; D013815:Thermodilution; D016278:Ventricular Function, Right / Q000502:physiology*; D015646:Ventriculography, First-Pass
D013670:Sodium Pertechnetate Tc 99m