Author + information
- Received February 10, 1986
- Revision received July 3, 1986
- Accepted August 22, 1986
- Published online January 1, 1987.
- Alain Bouchard, MD1,2,*,
- Steven Blumlein, MD1,
- Nelson B. Schiller, MD, FACC1,
- Steven Schlitt, MD1,
- Benjamin F. Byrd III, MD1,
- Thomas Ports, MD, FACC1 and
- Kanu Chatterjee, MD, FACC1
- ↵*Address for reprints: Alain Bouchard, MD, The University of Alabama at Birmingham, Department of Medicine, Division of Cardiovascular Disease, Room 321 Tinsley Harrison Tower, Birmingham, Alabama 35294.
A number of reports have described different Doppler echocardiography; methods to calculate left ventricular stroke volume and. cardiac output, but the clinical application of the noninvasive measurements of cardiac function remains in the early stages of development. This slow dissemination may be partly explained by the varying success of these ultrasound methods in determining accurate left ventricular stroke volume. The purpose of this study was to improve the simplicity and accuracy of Doppler stroke volume determination so that it could be more easily applied to patient management.
Stroke volume was measured using the product of the integral of aortic velocity obtained by continuous wave Doppler technique and the M-mode tracing of the aortic valve, validating the data against cardiac output obtained by thermodilution technique in 41 patients (r = 0.95, SEE = 7 cc). Intra- and interobserver variability was between 9 and 11%. The results of different sampling sites and the temporal relation between Doppler and thermodilution measurements were also studied. Analysis of 21 patients who had M-mode and two-dimensional echocardiographic studies of the aortic root revealed that the method using M-mode measurement of aortic valve area was most accurate in determining left ventricular stroke volume (r = 0.94, SEE = 10 cc), stroke volume being overestimated when area measurements of the ascending aorta were used.
In conclusion, maximal ascending aortic velocity determined by continuous wave Doppler echocardiography with M-mode measurement of aortic valve area can be used to calculate left ventricular stroke volume and cardiac output. The simplicity and practicality of this method should enhance the clinical application of Doppler echocardiography as a noninvasive monitoring technique.
- Received February 10, 1986.
- Revision received July 3, 1986.
- Accepted August 22, 1986.
- American College of Cardiology