PULSED DOPPLER ECHOCARDIOGRAPHIC DETERMINATION OF STROKE VOLUME AND CARDIAC-OUTPUT - CLINICAL VALIDATION OF 2 NEW METHODS USING THE APICAL WINDOW
PULSED DOPPLER ECHOCARDIOGRAPHIC DETERMINATION OF STROKE VOLUME AND CARDIAC-OUTPUT - CLINICAL VALIDATION OF 2 NEW METHODS USING THE APICAL WINDOW
复制标题
DOI：
10.1161/01.cir.70.3.425
复制
发表时间：
1984-01-01
期刊：
影响因子：
37.8
通讯作者：
QUINONES, MA
中科院分区：
文献类型：
--
作者：
LEWIS, JF;KUO, LC;QUINONES, MA
两种方法测量每搏输出量和心输出量，脉冲多普勒二维超声心动图，开发和验证对39例患者，其中33人在重症监护室的热稀释技术。通过使用心尖4腔视图，二尖瓣流入方法将二尖瓣环处的左心室流入的速度与环的横截面积组合，所述环的横截面积由其在中孔处的直径（面积+ π）计算。r2）。从心尖5腔视图，左心室流出方法将左心室流出速度与主动脉瓣环的横截面积相结合，根据收缩早期的直径计算（胸骨旁长轴视图）。分别在39例患者中的35例（90%）和39例（100%）中获得了二尖瓣流入和左心室流出方法的测量结果。二尖瓣方法的验证排除了二尖瓣返流患者（n = 11），左心室流出道方法的验证排除了主动脉瓣返流患者（n = 4）。二尖瓣环法（R = 0.96和0.87，分别）和左心室流出道法（R = 0.95和0.91，分别）的每搏输出量和心输出量的热稀释法和多普勒测量之间观察到良好的相关性。在无瓣膜损害的患者中，两种方法的结果彼此相关性良好。观察者间变异性更大的二尖瓣环方法，这是唯一相关的测量环直径的变异性更大。二尖瓣返流患者的左室流入量总是大于左室流出量，而主动脉瓣返流患者的情况则相反。因此，在适用时，可以使用二尖瓣流入或左心室流出方法从心尖准确测量每搏输出量和心输出量。比较这两种方法获得的体积可能对定量二尖瓣或主动脉瓣返流的严重程度有价值。
Two methods of measuring stroke volume and cardiac output, with pulsed Doppler 2-dimensional echocardiography, were developed and validated against the thermodilution technique in 39 patients, 33 of whom were in an intensive care unit. With the use of the apical 4-chamber view, a mitral inflow method combined the velocity of left ventricular inflow at the mitral anulus with the cross-sectional area of the anulus, calculated from its diameter at middiastole (area + .pi. r2). From the apical 5-chamber view, a left ventricular outflow method combined the velocity of left ventricular outflow with the cross-sectional area of the aortic anulus, calculated from its diameter during early systole (parasternal long-axis view). Measurements with the mitral inflow and left ventricular outflow methods were obtained in 35 of 39 (90%) and 39 of 39 (100%) patients, respectively. Validation of the mitral method excluded patients with mitral regurgitation (n = 11), and validation of the left ventricular outflow method excluded those with aortic regurgitation (n = 4). Good correlations were observed between thermodilution and Doppler measurements of stroke volume and cardiac output for both the mitral anulus method (R = 0.96 and 0.87, respectively) and the left ventricular outflow method (R = 0.95 and 0.91, respectively). The results of the 2 methods correlated well with each other in patients without regurgitant valve lesions. A greater interobserver variability was observed with the mitral anulus method, which was related solely to greater variability in measuring the annular diameter. In patients with mitral regurgitation, left ventricular inflow volume was always greater than left ventricular outflow stroke volume, while the inverse was true in those with aortic regurgitation. Thus, stroke volume and cardiac output can be accurately measured from the cardiac apex with mitral inflow or left ventricular outflow methods, when applicable. Comparison of volumes obtained with these 2 methods may prove valuable in quantitating the severity of mitral or aortic regurgitation.