The use of live three-dimensional Doppler echocardiography in the measurement of cardiac output - An in vivo animal study

Clinical Care Center for Congenital Heart Disease, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
Journal of the American College of Cardiology (Impact Factor: 16.5). 03/2005; 45(3):433-8. DOI: 10.1016/j.jacc.2004.10.046
Source: PubMed

ABSTRACT 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, R(2) = 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.

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Available from: David J Sahn, Sep 27, 2015
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    • "Recently, three-dimensional transesophageal echocardiography (3D TEE) was developed to provide superior image quality. Studies have revealed the advantages of this modality for assessing LV volume, mass, and output [9] [10] [11] and elucidating the 3D geometry of the mitral valve and annulus [12]. In this study, 3D TEE was utilized to provide fast, noninvasive , and accurate estimations of TV morphology. "
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    ABSTRACT: Background This study aimed to evaluate the relationship between tricuspid annular dilatation (TAD) and tricuspid regurgitation (TR), and the prognostic value of TAD using three-dimensional transesophageal echocardiography (3D TEE). Methods Tricuspid annular area (TAA) was measured in 116 patients using 3D TEE. Patients were classified into three groups (mild TR: n = 77, moderate TR: n = 26, severe TR: n = 13). Moreover, patients were classified into two groups based on rehospitalization for heart failure (HF); HF (+) group (n = 18) and HF (−) group (n = 98). Results TAA in the severe TR group was significantly larger than that in the mild and moderate TR groups (18.4 ± 3.8 cm2 vs. 11.7 ± 3.2 cm2, 12.3 ± 3.4 cm2, p < 0.05). TAA in the HF (+) group was significantly larger than that in the HF (−) group (16.8 ± 4.3 cm2 vs. 11.8 ± 3.3 cm2, p < 0.001). In receiver operating characteristics curve assessing the ability of TAA to predict hospitalization for HF, the area under the curve was 0.84. TAA ≥ 15 cm2 best predicted hospitalization for HF with 77.8% sensitivity and 84.6% specificity. The incidence of hospitalization for HF during 3 years was significantly higher in the TAD (+) group (TAA ≥ 15 cm2) than the TAD (−) group (48.3% vs 4.6%, p < 0.001). Conclusions The results of this study suggested a possible association between TAD and the TR severity. TAD estimated using 3D TEE may predict hospitalization for prospective HF.
    IJC Heart and Vessels 04/2014; 4(1). DOI:10.1016/j.ijchv.2014.04.009
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    • "By utilizing and extending these algorithms, more accurate measurements of flow rate and volume are possible. Also, there is potential to minimize the geometric assumptions involved in these measurements in a practical manner.9-11) Thavendiranathan et al.12) automatically quantified mitral inflow and LV outflow (LVOT) stroke volumes (SV) by real time 3D full volume color Doppler echocardiography (FVCD) and compared these results with those from 2D pulsed-wave (PW) Doppler and cardiac magnetic resonance imaging (CMR). "
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    ABSTRACT: Accurate assessment of mitral regurgitation (MR) severity is crucial for clinical decision-making and optimizing patient outcomes. Recent advances in real-time three dimensional (3D) echocardiography provide the option of real-time full volume color Doppler echocardiography (FVCD) measurements. This makes it practical to quantify MR by subtracting aortic stroke volume from the volume of mitral inflow in an automated manner. Thirty-two patients with more than a moderate degree of MR assessed by transthoracic echocardiography (TTE) were consecutively enrolled during this study. MR volume was measured by 1) two dimensional (2D) Doppler TTE, using the proximal isovelocity surface area (PISA) and the volumetric quantification methods (VM). Then, 2) real time 3D-FVCD was subsequently obtained, and dedicated software was used to quantify the MR volume. MR volume was also measured using 3) phase contrast cardiac magnetic resonance imaging (PC-CMR). In each patient, all these measurements were obtained within the same day. Automated MR quantification was feasible in 30 of 32 patients. The mean regurgitant volume quantified by 2D-PISA, 2D-VM, 3D-FVCD, and PC-CMR was 72.1 ± 27.7, 79.9 ± 36.9, 69.9 ± 31.5, and 64.2 ± 30.7 mL, respectively (p = 0.304). There was an excellent correlation between the MR volume measured by PC-CMR and 3D-FVCD (r = 0.85, 95% CI 0.70-0.93, p < 0.001). Compared with PC-CMR, Bland-Altman analysis for 3D-FVCD showed a good agreement (2 standard deviations: 34.3 mL) than did 2D-PISA or 2D-VM (60.0 and 62.8 mL, respectively). Automated quantification of MR with 3D-FVCD is feasible and accurate. It is a promising tool for the real-time 3D echocardiographic assessment of patients with MR.
    Journal of cardiovascular ultrasound 06/2013; 21(2):81-9. DOI:10.4250/jcu.2013.21.2.81
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    • "Since the solution provided is already limited and only allows to estimate some regional changes in vascularity, applicable perhaps to the abovementioned DVS and to placenta (Odeh et al. 2011), but is still far away from depicting the flow phenomenon; it is necessary to move forward, towards two recently opened gates: First is the integration of Power Doppler signal derived velocities profile, whose most reliable approach is the Surface Integration of Velocity Vectors ,(Sun et al. 1995; J M Rubin et al. 2001; Berg et al. 2000) a clarifying concept which was developed for Color Dopler signal analysis, but has the handicap of the angle effect (Pemberton et al. 2005; Li et al. 2005), reason why it was left aside. Until the algorithms for calculating velocity of particles from power Doppler signals were developed (M. "
    Sonography, 02/2012; , ISBN: 978-953-307-947-9
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