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European Journal of Echocardiography Advance Access originally published online on July 9, 2007
European Journal of Echocardiography 2008 9(3):334-337; doi:10.1016/j.euje.2007.03.033
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

Measurement of cardiac output by real-time 3D echocardiography in patients undergoing assessment for cardiac transplantation

Stephen P. Hoole1, James Boyd1, Vlasis Ninios2, Jayan Parameshwar2 and Rosemary A. Rusk1,*

1 Department of Echocardiography, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridgeshire CB23 8RE, UK
2 Department of Cardiac Transplantation, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridgeshire CB23 8RE, UK

Received 19 December 2006; accepted after revision 31 March 2007; online publish-ahead-of-print 9 July 2007.

* Corresponding author. Tel: +44 1480 364 769; fax: +44 1480 364 355. E-mail address: rosemary.rusk{at}papworth.nhs.uk


  Abstract

Aims: Heart transplant assessment includes cardiac output calculation by right heart catheterisation. Real-time 3D echocardiography (RT-3DE), unlike 2D echocardiography, can measure stroke volume without inaccurate geometrical assumptions. The purpose of this study was to assess the feasibility and accuracy of non-invasive RT-3DE cardiac output calculation.

Methods and results: Forty consecutive patients referred for transplant assessment underwent transthoracic RT-3DE. Full volume 3DE data sets were acquired from apical views with the iE33 ultrasound system (Philips Ultrasound, Bothell, USA). Four patients were excluded due to poor image quality. The remaining 36 patients had end-diastolic (LVEDV) and end-systolic (LVESV) left ventricular volumes manually traced, using endocardial detection software. Cardiac output was subsequently calculated: [(LVEDV – LVESV) x heart rate]. Thermodilution derived cardiac outputs, under the same haemodynamic conditions, were used as reference for comparison. There was close correlation between RT-3DE and catheter derived cardiac outputs (r = 0.91, y = 0.86x + 0.45, SEE 0.39 L/min, mean difference from reference –0.06 L/min, SD 0.40 L/min). RT-3DE data analysis took 3 min per case.

Conclusion: This study shows RT-3DE is an accurate method for calculating cardiac output. In patients requiring serial evaluation of cardiac function, this non-invasive test may be preferable to invasive right heart catheterisation.

Keywords: Real-time 3D echocardiography; Cardiac output; Cardiac transplant assessment


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