[Interobserver and spontaneous variability of Doppler echocardiography measured cardiac output in children with congenital heart defects].
Doppler-derived cardiac output (CO) measurements were performed on 2 consecutive days in 30 children with surgically corrected congenital heart diseases. The children formed three subgroups of 10 patients each according to age (group 1 = less than 1 year, 2 = 1-5 years, 3 = greater than 5 years). Pulsed Doppler recordings were carried out over pulmonary and aortic valves using standard projections. All recordings were "blindly" evaluated by two independent investigators. In each age group day-to-day and interobserver variability were assessed for CO, cross-sectional area of the vessel (A), time-velocity integral (I), and heart rate (HR). Day-to-day variability for CO ranged between 20% and 33% depending on age and sampling site. The corresponding variabilities for A, I, and HR were 19-35%, 14-23%, and 9-11%, respectively. Spontaneous variability did not differ significantly between the three age groups. Interobserver variabilities for CO, I, A, and HR were 13-40%, 14-32%, 20-55%, and 1-3%, respectively. A of the aorta in group 1 and aortic I in group 3 were significantly different (p less than 0.05) for both observers. None of the remaining parameters, measured by both observers, were significantly different. CO and I revealed a higher interobserver variability (p less than 0.01) for infants (group 1) than for older children, when determined over the pulmonary valve. In addition, interobserver variability of aortic cross-sectional area was significantly increased (p less than 0.01) for the young age group (group 1). We conclude that there is a considerable spontaneous and interobserver variability of Doppler-derived CO measurements in pediatric patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Stern
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Deutsches Herzzentrum München, Kinderkardiologie.
Haberhauer
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P
Emmrich
P
P
Bühlmeyer
K
K
D001021:Aortic Valve / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D007223:Infant
Interbeobachter- und Spontanvariabilität dopplerechokardiographisch gemessener Herzminutenvolumina bei Kindern mit angeborenen Herzfehlern.