Evaluation of cardiac function by echo-Doppler studies in critically ill patients

Abstract

Measurements of stroke volume (SV) by echo-Doppler techniques (2D-echocardiography, continuous and pulsed Doppler) were compared to those obtained by thermodilution in 116 critically ill patients. The best correlation was obtained with pulsed Doppler positioned in the left ventricular (LV) outflow (r = 0.78, p less than 0.001). In a subgroup of 12 patients who had LV ejection fraction less than 60% and LV end-diastolic pressure greater than 15 mmHg, we also measured the peak aortic blood velocity (PABV) and acceleration (PABA) by continuous and pulsed Doppler as indexes of myocardial contractility before coronary artery bypass graft. When compared to healthy volunteers, these patients had decreased PABV and PABA, measured by continuous Doppler (91 +/- 16 vs 79 +/- 9 cm/s, p less than 0.05 and 913 +/- 202 vs 660 +/- 149 cm/s/s, p less than 0.05, respectively). These data therefore indicate that in critically ill patients pulsed Doppler placed in the LV outflow is an adequate echo-Doppler technique to measure SV, while continuous Doppler placed in the suprasternal notch can be used to assess LV performance.

Short-Term Statin Therapy Improves Cardiac Function and Symptoms in Patients With Idiopathic Dilated Cardiomyopathy

“…Left ventricular volumes were calculated using Teichholtz's formula and used to determine LVEF. 11 All echocardiograms were read by the same physician, who was blinded to patients' treatment, assignment, and time point.…”

Impact of Blockade of Histamine H2Receptors on Chronic Heart Failure Revealed by Retrospective and Prospective Randomized Studies

“…The personnel performing these assays were blinded to the patients' treatment assignments. M-mode echocardiography was performed with 2-dimensional monitoring using a Sono layer phased-array sector scanner (SONOS 5500, Hewlett Packard, Palo Alto, California) before and after 24 weeks of the treatment with famotidine or teprenone (18). All echocardiograms were read by the same physician, at baseline and after 24 weeks of the treatment, who was blinded to patients' treatment, assignment, and time point.…”

Human immunodeficiency virus infection and systolic myocardial performance

“…An accurate quantitation of LV systolic performance is thus desirable. The ability of Doppler echocardiography to measure aortic blood flow parameters reliably in the ascending aorta has led to its use in the noninvasive assessment of LV performance [17][18][19][20][21][22][23][24][25]. The Doppler technique has one advantage over M-mode and 2-D echocardiography: it can detect even modest changes in global LV systolic function [17,26] where conventional echocardiography fails to do so by missing the detection of small areas of hypokinesia.…”

“…Quantitative studies are too laborious to be performed routinely and are not always accurate. Doppler study of ascending aortic flow provides an effective, simple, and quantitative method of detecting global LV systolic dysfunction and of assessing shortterm changes in LV performance [17][18][19][20][21][22][23][24][25]. The tech-nique could possibly be more sensitive than 2-D echocardiography in detecting modest changes of LV function [26].…”