Comparative value of eight M-mode echocardiographic formulas for determining left ventricular stroke volume. A correlative study with thermodilution and left ventricular single-plane cineangiography.
Comparative value of eight M-mode echocardiographic formulas for determining left ventricular stroke volume. A correlative study with thermodilution and left ventricular single-plane cineangiography.
复制标题
八种 M 型超声心动图公式确定左心室每搏量的比较价值。
作者：
G. Kronik;J. Slany;H. Mösslacher
连续66例无左心室容量超负荷、显著心律失常或显著心包积液的患者在诊断性左、右心导管插入术前立即进行M型超声心动图检查。使用各种超声心动图测量，左心室每搏输出量（SV）计算根据8个不同的超声心动图公式（SVE），已提出的。在导管插入术时，还通过热稀释法（SVT）和右前斜投影（SVA）的单平面左心室电影血管造影术确定SV。当比较SVE与SVT时，开发用于计算二尖瓣或主动脉瓣流量的四个公式失败（r = 0.10至0.54）。正如预期的那样，当用于从心室直径计算心室容积或从直径变化计算SV的公式（左心室公式）用于心室收缩模式严重不对称的冠状动脉患者时，也发现相关性较差（r = 0.22至0.47）。当左室公式仅用于对称或几乎对称收缩的患者时，两个公式分别产生了良好的相关性r = 0.84，SEE = 12.7ml和r = 0.86，SEE = 12.2ml。这些相关性与我们的两种有创参考技术之间的相关性（r = 0.81; SEE = 12.2 ml）相当。SVE和SVA之间的比较证实了热稀释研究的结果，尽管相关性通常较弱。我们得出结论，Teichholz等人的公式，这是最好的所有测试公式，可用于获得一个临床上有用的估计SV的患者中，对称或几乎对称的左心室收缩可以预期。
Sixty-six consecutive patients without left ventricular volume overload, significant arrhythmia or significant pericardial effusion were examined by M-mode echocardiography immediately before diagnostic left- and right-heart catheterization. Using various echocardiographic measurements, left ventricular stroke volume (SV) was calculated according to eight different echocardiographic formulas (SVE) that have been proposed previously. At catheterization SV was also determined by thermodilution (SVT) and by single-plane left ventricular cineangiography in the right anterior oblique projection (SVA). When comparing SVE with SVT, the four formulas developed to calculate mitral or aortic flow failed (r = 0.10 to 0.54). As expected, poor correlations (r = 0.22 to 0.47) were also found when formulas used to calculate ventricular volumes from the ventricular diameter or SV from the change in diameter (left ventricular formulas) were used in coronary patients with grossly asymmetrical ventricular contraction patterns. When the use of the left ventricular formulas was confined to patients with symmetrical or almost symmetrical contraction, two formulas yielded favorable correlations of r = 0.84, SEE = 12.7 ml and r = 0.86, SEE = 12.2 ml, respectively. These correlations were comparable to the correlation between our two invasive reference techniques (r = 0.81; SEE = 12.2 ml). The comparison between SVE and SVA confirmed the results of the thermodilution study, though the correlations were generally weaker. We conclude that the formula of Teichholz et al., which was the best of all tested formulas, may be used to obtain a clinically useful estimate of SV in patients in whom symmetrical or almost symmetrical left ventricular contraction can be anticipated.