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Abstract: Poster Presentations |

Correlation Between Noninvasive and Invasive Cardiac Index (CI): Utilization of Noninvasive Echocardiographic Doppler-Derived Index of Myocardial Performance (IMP) FREE TO VIEW

Ajeet D. Sharma, MD; John C. Lucke, MD; Antoine Al-Achi, Ph.D; John Kelemen, MD; Peter McKeown, MD; Ross W. MacIntyre, MD; James Calderbank, MD; Anil K. Sharma, MD
Author and Funding Information

VA Asheville Medical Center, Asheville, NC


Chest


Chest. 2003;124(4_MeetingAbstracts):186S. doi:10.1378/chest.124.4_MeetingAbstracts.186S
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Abstract

PURPOSE:  Dr Tei described a doppler index for the assessment of global left ventricular performance termed the Index of myocardial performance (IMP). IMP encompasses left ventricular (LV) systolic contraction, ejection, and diastolic relaxation, and is independent of heart rate (HR), and mean blood pressure (MBP). Diminished LV function is associated with prolongation of IMP (>0.55 seconds). Doppler IMP can be utilized to calculate CI noninvasively. The purpose of this study was to assess whether noninvasive post-cardiopulmonary bypass (CPB) derived CI calculated by the equation [CI x IMP {pre-CPB} = CI x IMP {post-CPB} correlated with standard invasive thermodilution pulmonary artery catheter (PAC) derived CI.

METHODS:  50 adult patients who underwent elective cardiac surgery were studied. Pre-CPB IMP and CI were calculated before sternotomy with the aid of transesophageal echocardiography (TEE). IMP was calculated by the equation in figure 1. CI was calculated by the doppler hemodynamic equation [CI=0.785 x (LVOT diameter x 2 (cm) x LVOT TVI (cm) x HR/BSA; where LVOT: left ventricular outflow tract; TVI: time velocity integral, BSA: body surface area]. Post-CPB, IMP was calculated 15 minutes following termination of CPB. Pre-CPB (IMP and CI value) and post-CPB (IMP value only) were then applied to the equation (CI x IMP {pre-CPB}= (CI x IMP){post-CPB}and a predicted noninvasive value of post-CPB CI was calculated. This noninvasive CI value was correlated with post-CPB invasive CI recorded from the pulmonary artery catheter (PAC).

RESULTS:  There is linear relationship between the predicted (noninvasive) CI measurement and invasive CI measurement [p<0.0001;r=0.67](Fig 2). Data analyzed by a linear regression method and Bayes’ rule of probability.CONCLUSIONS: This study establishes that noninvasive IMP can be utilized in the calculation of CI, and that there is excellent correlation between predicted (noninvasive) CI and invasive CI.CLINICAL APPLICATIONS: Echocardiographic doppler derived IMP can be utilized in the assessment of noninvasive CI. This could provide a practical and safer alternative to more invasive methods of measuring CI

DISCLOSURE:  A.D. Sharma, None.

Wednesday, October 29, 2003

12:30 PM - 2:00 PM


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