Transcardiac conductance for continuous measurement of left ventricular volume: validation vs. angiography in patients.
OBJECTIVE
To test the feasibility of the transcardiac conductance (TCC) method for continuous, on-line measurement of absolute left ventricular (LV) volume and to validate the method by comparison with biplane angiography.


METHODS
Prospective clinical feasibility and validation study in a cardiac catheterization laboratory in a university hospital.


METHODS
Ten patients scheduled for electrophysiological studies ( n=5), percutaneous transluminal coronary angioplasty ( n=3), and left- and right-sided cardiac catheterization ( n=2) were enrolled in the feasibility study. Twenty patients scheduled for diagnostic left- and right-sided cardiac catheterization were included in the validation study. The latter were studied at baseline and during right atrial pacing 30 beats/min above baseline.


RESULTS
In the feasibility study satisfactory ventricular volume signals were obtained by TCC in eight of ten patients. In the validation study calibration factors (alpha and V(p)) for TCC were obtained by thermodilution and hypertonic saline dilution, to yield absolute LV volume. Results indicate a good linear correlation with angiographic volume ( R(2)=0.78) with an intercept of 10+/-15 ml, not significantly different from 0 and slope of 1.17+/-0.16. Mean calibration factors alpha and V(p) were 0.017+/-0.002 (interpatient variability 0.018) and 75.1+/-0.4 ml (interpatient variability 35.4 ml), respectively.


CONCLUSIONS
The TCC method provides on-line and continuous LV volume signals in patients in a relatively noninvasive way. Calibration yields absolute LV volumes with a good linear correlation in comparison to biplane LV angiography. TCC appears to be a promising methodology for monitoring absolute LV volume in the ICU.
Staal
Eva M
EM
Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Baan
Jan
J
Jukema
J Wouter
JW
van der Wall
Ernst E
EE
Steendijk
Paul
P
D000368:Aged; D000465:Algorithms; D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization / Q000379:methods; D002306:Cardiac Volume / Q000502:physiology*; D017023:Coronary Angiography / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*