Combined Doppler and echocardiographic measurement of cardiac output: theory and application in pregnancy

Robson, S. C.; Dunlop, W.; Moore, Myles N; Hunter, Stewart

doi:10.1111/j.1471-0528.1987.tb02285.x

Cited by 123 publications

(75 citation statements)

References 47 publications

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“…The luminal crosssectional area was calculated from ascending aortic diameter [area ϭ (diameter/2) 2 ] measured from the vascular casts. Mean blood velocity and stroke distance were multiplied by luminal cross-sectional area to obtain cardiac output and stroke volume, respectively (25,36). Because vessel area was measured from casts obtained at necropsy, these variables were calculated once at the last time point in each group.…”

Section: Methodsmentioning

confidence: 99%

Maternal cardiovascular changes during pregnancy and postpartum in mice

Wong

Kulandavelu

Whiteley

et al. 2002

American Journal of Physiology-Heart and Circulatory Physiology

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Genetically altered mice may provide useful models for exploring cardiovascular regulation during pregnancy and postpartum if changes in mice mimic humans. We found in awake ICR (CD-1) mice at 17.5 days gestation that hematocrit was reduced 18%, and the pressor response to intravenous angiotensin II was reduced ∼33%. Arterial pressure in awake mice was 12% lower in early pregnancy (3.5 days) than late pregnancy (17.5 days) and postpartum (3 and 17 days after delivery), whereas heart rate was 10–20% higher in the peripartum period (17.5 days gestation and 3 days postpartum). In late pregnancy, cardiac output under isoflurane anesthesia was 64% higher than in nonpregnant mice, due to a 37% increase in stroke volume and a 17% increase in heart rate. All changes P < 0.05. We conclude that, as in humans, mice exhibit hypotension in early pregnancy, and a blunted pressor response to angiotensin II, a decrease in hematocrit, and a marked increase in cardiac output in late pregnancy.

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Section: Methodsmentioning

confidence: 99%

Maternal cardiovascular changes during pregnancy and postpartum in mice

Wong

Kulandavelu

Whiteley

et al. 2002

American Journal of Physiology-Heart and Circulatory Physiology

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“…The mean length of survival after transplantation was 11 (range [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] months and all patients were receiving standard immunosuppressive treatment (prednisolone, azathioprine, and cyclosporin). In all cases a recent cardiac biopsy specimen had shown no evidence of rejection.…”

Section: Methodsmentioning

confidence: 99%

Isometric exercise in the denervated heart: a Doppler echocardiographic study.

Robson

Furniss

Heads

et al. 1989

Heart

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SUMMARY The haemodynamic responses to isometric exercise of eight recipients of orthotopic heart transplants and eight healthy controls were studied. Each performed sustained exercise at 30% of maximal voluntary contraction for three minutes on a handgrip dynamometer. Cardiac output was measured by combined Doppler and cross sectional echocardiography before exercise and every 30 seconds during and after exercise. In the controls cardiac output and blood pressure increased significantly owing to an increase in heart rate with no change in stroke volume. In the transplant group cardiac output, heart rate, and stroke volume remained unchanged throughout exercise.In contrast with its response to dynamic exercise the denervated human heart is unable to increase cardiac output during isometric exercise. The pressor response that occurs is mediated via an increase in peripheral vascular resistance.Although reinnervation of the transplanted heart has been well documented after orthotopic transplantation of the canine heart,' the transplanted human heart seems to remain both functionally and anatomically denervated indefinitely.2 Studies in normally innervated human hearts have shown that isometric exercise results in significant increases in cardiac output, heart rate, and mean blood pressure without changes in stroke volume, ventricular dimensions, or myocardial contractility." Although the transplanted denervated heart is able to maintain a relatively normal cardiac output during dynamic exercise' through the Frank-Starling mechanism, it is difficult to envisage how it can produce an appropriate increase in cardiac output during semisupine static exercise.Cardiac output can be calculated from blood velocity in the ascending aorta, measured by Doppler ultrasound, combined with aortic orifice area, measured by cross sectional echocardiography.9"0 The technique is reproducible" 12 and allows quick, non-invasive measurements of cardiac output both at rest and during supine and upright exercise."'5 Left ventricular size and performance can be accuratelyRequests for reprints to Dr S S Furniss, Regional Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN.Accepted for publication 29 November 1988 measured by M mode echocardiography.'6 '7 We used these techniques to investigate the haemodynamic changes during handgrip isometric exercise in recipients of orthotopic heart transplants and in controls. Patients and methodsEight recipients of orthotopic heart transplants (six men) were recruited. The details of the group were as follows: mean (SD) age 40 (10) years, mean (SD) height 1-71 (0-08) m, mean (SD) weight 64-8 (9.5) kg.All patients were clinically and functionally well with no clinically significant biochemical or haematological abnormality at the time of the study.Mean haemoglobin was 12 3 g/l and mean creatinine clearance was 58 ml/min. The mean length of survival after transplantation was 11 (range 5-21) months and all patients were receiving standard immunosuppressive treatment (prednisolone, azath...

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“…These changes begin to reverse shortly after delivery and continue to decrease over the next 24 hours, resolving over the next 6 to 8 weeks. [59][60][61]120,121 The extravascular fluid accumulation that occurs during gestation will typically resolve over a similar time interval.…”

Section: Clinical Statements and Guidelinesmentioning

confidence: 99%

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

Canobbio¹,

Warnes²,

Aboulhosn³

et al. 2017

Circulation

339

303

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Today, most female children born with congenital heart disease will reach childbearing age. For many women with complex congenital heart disease, carrying a pregnancy carries a moderate to high risk for both the mother and her fetus. Many such women, however, do not have access to adult congenital heart disease tertiary centers with experienced reproductive programs. Therefore, it is important that all practitioners who will be managing these women have current information not only on preconception counseling and diagnostic evaluation to determine maternal and fetal risk but also on how to manage them once they are pregnant and when to refer them to a regional center with expertise in pregnancy management.

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Combined Doppler and echocardiographic measurement of cardiac output: theory and application in pregnancy

Cited by 123 publications

References 47 publications

Maternal cardiovascular changes during pregnancy and postpartum in mice

Maternal cardiovascular changes during pregnancy and postpartum in mice

Isometric exercise in the denervated heart: a Doppler echocardiographic study.

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

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