The use of live three-dimensional Doppler echocardiography in the measurement of cardiac output

• Published in: Journal of the American College of Cardiology Vol. 45; no. 3; pp. 433 - 438
• Main Authors: Pemberton, James, Li, Xiaokui, Karamlou, Tara, Sandquist, Chloe A., Thiele, Karl, Shen, Irving, Ungerleider, Ross M., Kenny, Antoinette, Sahn, David J.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.02.2005
• Subjects: CPB; AV; PW; 2-D; 3-D; 2-DE; CO; LVOT; 3-DE
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2004.10.046

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. 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. 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. 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). 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.