Utility and limitations of biplane transesophageal echocardiographic automated border detection for estimation of left ventricular stroke volume and cardiac output.
Recent echocardiographic ABD algorithms can estimate LV volume on-line from a single long-axis plane. The objective of this study was to assess the capability and limitations of transesophageal ABD to estimate stroke volume and cardiac output in patients before and after coronary artery bypass surgery by correlating these data with simultaneous thermodilution measurements. ABD data were acquired on-line from the transverse-plane four-chamber view and the longitudinal-plane two-chamber view and calculated by automated area-length and Simpson's rule formulas for volume. Thirty-three studies were attempted in 18 patients. Technically adequate ABD data were available in all patients from at least one view. Twenty-two (67%) of 33 studies from the four-chamber view and 27 (82%) of 33 studies from the two-chamber view were technically adequate. Cardiac output by all ABD methods was significantly correlated with thermodilution values (r range 0.72 to 0.89; SEE range 0.48 to 0.55 L/min). The two-chamber view underestimated cardiac output slightly, by an average of 0.4 L/min, whereas the four-chamber view consistently underestimated cardiac output by an average of 1.9 L/min. The area-length and Simpson's rule algorithms produced similar results. Biplane transesophageal ABD is an alternative method for estimating cardiac output; the two-chamber view in particular has potential for on-line volume determination.
Division of Cardiology, University of Pittsburgh Medical Center, PA 15261.
W E
WE
Katz
T A
TA
Gasior
S C
SC
Reddy
J
J
Gorcsan
D000328:Adult; D000368:Aged; D000465:Algorithms; D002302:Cardiac Output; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D013318:Stroke Volume