A Doppler echocardiographic method for calculating volume flow across the tricuspid valve: correlative laboratory and clinical studies.
In this study we tested a two-dimensional Doppler echocardiographic method for measuring volume flow across the tricuspid valve. Five anesthetized, open-chest dogs had a calibrated electromagnetic flow probe placed on the ascending aorta. Volume flow across the tricuspid valve was controlled by creating a variable femoral-to-pulmonary arterial shunt. Since no standard plane provided a direct view of the tricuspid valve orifice, tricuspid flow area was estimated by calculating a fixed circular flow orifice from the maximal late diastolic diameter of the tricuspid anulus in a four-chamber view. Doppler-determined velocities across the tricuspid valve and tricuspid anulus images in the four-chamber view were obtained in inspiration and expiration. For 24 cardiac outputs (0.6 to 4.0 liters/min), inspiratory tricuspid flow determined by the Doppler method correlated minimally better (r = .90, SEE = 0.30 liter/min) than did expiratory measurements (r = .89, SEE = 0.35 liter/min) with the time-averaged systemic flow determined electromagnetically. Doppler-determined tricuspid volume flows in four-chamber and short-axis two-dimensional echocardiographic views from 10 children were then compared with values determined simultaneously by thermodilution during cardiac catheterization. In the children, Doppler-determined flows in short-axis and four-chamber views, both in inspiration and expiration, were similar; when results for the two views were averaged in inspiration and expiration, the tricuspid flows predicted by the Doppler method were highly correlated (r = .98, SEE = 0.48 liter/min) with the results of thermodilution. The two-dimensional Doppler echocardiographic method provides a means of estimating volume flow across the tricuspid valve noninvasively.
D000293:Adolescent; D000818:Animals; D001017:Aortic Coarctation / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000503:physiopathology; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D002302:Cardiac Output; D002306:Cardiac Volume; D002648:Child; D002675:Child, Preschool; D003326:Coronary Circulation; D004285:Dogs; D004452:Echocardiography / Q000379:methods*; D006801:Humans; D007223:Infant; D014261:Tricuspid Valve / Q000502:physiology*