CLINICAL RESEARCH: ECHOCARDIOGRAPHY
The use of live three-dimensional Doppler echocardiography in the measurement of cardiac output
An in vivo animal study
James Pemberton, MD*,
Xiaokui Li, MD*,
Tara Karamlou, MD ,
Chloe A. Sandquist, MD ,
Karl Thiele, PhD ,
Irving Shen, MD ,
Ross M. Ungerleider, MD ,
Antoinette Kenny, MD and
David J. Sahn, MD, MACC*,*
* *Clinical Care Center for Congenital Heart Disease
Department of Pediatric Cardiac Surgery, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon
Philips Medical Systems, Andover, Massachusetts
Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
Manuscript received August 18, 2004;
revised manuscript received October 5, 2004,
accepted October 12, 2004.
* Reprint requests and correspondence: Dr. David J. Sahn, The Clinical Center for Congenital Heart Disease, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, L608, Portland, Oregon, 97239-3098
(Email: sahnd{at}ohsu.edu).
OBJECTIVES: The purpose of this study was to investigate whether cardiac output (CO) could be accurately computed from live three-dimensional (3-D) Doppler echocardiographic data in an acute open-chested animal preparation.
BACKGROUND: The accurate measurement of CO is important in both patient management and research. Current methods use invasive pulmonary artery catheters or two-dimensional (2-D) echocardiography or esophageal aortic Doppler measures, with the inherent risks and inaccuracies of these techniques.
METHODS: Seventeen juvenile, open-chested pigs were studied before undergoing a separate cardiopulmonary bypass procedure. Live 3-D Doppler echocardiography images of the left ventricular outflow tract and aortic valve were obtained by epicardial scanning, using a Philips Medical Systems (Andover, Massachusetts) Sonos 7500 Live 3-D Echo system with a 2.5-MHz probe. Simultaneous CO measurements were obtained from an ultrasonic flow probe placed around the aortic root. Subsequent offline processing using custom software computed the CO from the digital 3-D Doppler DICOM data, and this was compared to the gold standard of the aortic flow probe measurements.
RESULTS: One hundred forty-three individual CO measurements were taken from 16 pigs, one being excluded because of severe aortic regurgitation. There was good correlation between the 3-D Doppler and flow probe methods of CO measurement (y = 1.1x 9.82, R2 = 0.93).
CONCLUSIONS: In this acute animal preparation, live 3-D Doppler echocardiographic data allowed for accurate assessment of CO as compared to the ultrasonic flow probe measurement.
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Abbreviations and Acronyms
| | AV = aortic valve | | CO = cardiac output | | CPB = cardiopulmonary bypass | | LVOT = left ventricular outflow tract | | PW = pulse wave | | 2-D = two-dimensional | | 2-DE = two-dimensional echocardiography | | 3-D = three-dimensional | | 3-DE = three-dimensional echocardiography |
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