title: Poor correlation between hemodynamic and echocardiographic indexes of left ventricular performance in the operating room and intensive care unit.
abstract: OBJECTIVE
  To compare hemodynamic and echocardiographic indexes of left ventricular performance.
  
  
  METHODS
  Retrospective database analysis of four clinical trials.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Cardiac surgery patients.
  
  
  METHODS
  Left ventricular performance was evaluated using left ventricular stroke work index (LVSWI) calculated from the pulmonary artery catheter and both fractional area change and regional wall motion score index (RWMSI) measured from transesophageal echocardiography. Measures of left ventricular performance were obtained before and after bypass (group 1, n = 30), during acute increase and decrease in preload (group 2, n = 14), after administration of inhaled prostacyclin or placebo in patients with pulmonary hypertension (group 3, n = 20), and in hemodynamically unstable patients in the intensive care unit at admission and at 2 and 4 hrs (group 4, n = 20).
  
  
  RESULTS
  A total of 186 simultaneous LVSWI, fractional area change, and RWMSI were analyzed and compared. Patients with RWMSI <1.3 had a LVSWI of 23.4 +/- 10.3 g.m.m compared with 18.4 +/- 7.2 g.m.m in those with RWMSI >1.3 (p =.0349). Subdividing fractional area change into three different groups (> or =50%, 25% to 49%, and < or =24%), the corresponding values of LVSWI were 22.3 +/- 9.7 g.m.m, 22.2 +/- 10.8 g.m.m, and 17.7 +/- 5.5 g.m.m, respectively (p =.5114). Correlations between LVSWI and RWMSI changes ranged from -0.28 to 0.16 (p values from.31 to.94). Correlations between LVSWI and fractional area change changes ranged from -0.62 to 0.22 (p values from.07 to.95).
  
  
  CONCLUSIONS
  There is a significant discrepancy and limited relationship between the hemodynamic and echocardiographic evaluation of left ventricular performance.
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Montreal, Quebec, Canada.
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Bouchard
authors.forename: André
authors.initials: A
authors.lastname: Denault
authors.forename: Pierre
authors.initials: P
authors.lastname: Couture
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Guertin
authors.forename: Denis
authors.initials: D
authors.lastname: Babin
authors.forename: Paul
authors.initials: P
authors.lastname: Ouellet
authors.forename: Michel
authors.initials: M
authors.lastname: Carrier
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardif
mesh_terms: D000704:Analysis of Variance; D006348:Cardiac Surgical Procedures; D002407:Catheterization, Swan-Ganz; D017548:Echocardiography, Transesophageal; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D019990:Perioperative Care; D012189:Retrospective Studies; D016277:Ventricular Function, Left