A Comparison of Left Ventricular Performance Indices Measured by Transesophageal Echocardiography with Automated Border Detection 

1998 ◽  
Vol 89 (2) ◽  
pp. 341-349 ◽  
Author(s):  
Christ Declerck ◽  
Zak Hillel ◽  
Henry Shih ◽  
Maxine Kuroda ◽  
Cliff P. Connery ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Transesophageal Echocardiography ◽  
Minimum Alveolar Concentration ◽  
Myocardial Revascularization ◽  
Volatile Anesthetic ◽  
Left Ventricular ◽  
Ventricular Catheter ◽  
Border Detection ◽  
Ventricular Performance ◽  
Volatile Anesthetic Agent

Background Automated border detection (ABD) allows semiautomated measurement of left ventricular (LV) areas. They can be combined with left ventricular pressure signals to generate pressure-area loops and pressure-dimension indices of contractility. This study compared conventional indices of ventricular performance (fractional area change [FAC] and circumferential fiber shortening [Vcfc]) with pressure-dimension indices of contractility. A secondary aim was to compare the effects of volatile anesthetics on the indices. Methods Using transesophageal echocardiography with automated border detection, FAC and Vcfc were obtained in 23 patients after cardiopulmonary bypass. Left ventricular pressures were obtained with a left ventricular catheter. Preload reduction by inferior vena caval occlusion was used to obtain end-systolic elastance (Ees), preload recruitable stroke force (PRSF), and dP/dtmax x EDA(-1) (EDA = end-diastolic area). In 11 patients, the measurements were repeated at 1 end-tidal minimum alveolar concentration of halothane or isoflurane. The results are expressed as mean +/- SD. Results After cardiopulmonary bypass, FAC was 31.1+/-7.9%, Vcfc was 0.6+/-0.2 circ x s(-1), Ees was 25.8+/-11.6 mmHg x cm(-2), PRSF was 60.8+/-26.6 mmHg, and dP/dtmax x EDA(-1) was 245+/-123.4 mmHg x s(-1) x cm(-2). At 1 minimum alveolar concentration of a volatile anesthetic agent, FAC, Vcfc, and dP/dtmax x EDA(-1) remained unchanged. Significant decreases in Ees (19%) and PRSF (28%) were observed. Conclusions The association between pressure-dimension indices and Vcfc or FAC was weak or nonexistent. A reduction in myocardial contractility induced by the administration of volatile anesthetic agents was detected by Ees and PRSF, but not by FAC, Vcfc, or dP/dtmax x EDA(-1). After myocardial revascularization, Ees and PRSF appear more sensitive than FAC or Vcfc for measuring changes in contractility.

Prevention of Methacholine-induced Changes in Respiratory Mechanics in Piglets

1997 ◽  
Vol 87 (3) ◽  
pp. 585-590 ◽  
Author(s):  
Walid Habre ◽  
Johannes H. Wildhaber ◽  
Peter D. Sly
Keyword(s):  
Respiratory Mechanics ◽  
Minimum Alveolar Concentration ◽  
Volatile Anesthetic ◽  
Lung Compliance ◽  
Control Group ◽  
Alveolar Pressure ◽  
Insufficient Information ◽  
Volatile Anesthetic Agent ◽  
Airway Opening ◽  
Induced Changes

Background Sevoflurane is a new volatile anesthetic agent that may be a useful alternative to halothane for anesthesia in children. However, there is insufficient information about its effects on respiratory mechanics, particularly in the presence of constrictor stimuli. Methods Eighteen piglets had anesthesia induced and maintained with either pentobarbital (control: n = 8), 1 minimum alveolar concentration (MAC) sevoflurane (sevo: n = 5), or 1 MAC halothane (halo: n = 5). Pressure, flow, and volume were measured at the airway opening and used to calculate lung compliance (C(L)) and resistance (R(L)). Resistance was partitioned into airway (Raw) and parenchymal (Vti) components using alveolar pressure. Methacholine was infused intravenously in a dose sufficient (15 microg x kg(-1) x h(-1)) to approximately double R(L). Results The increase in R(L) seen in the control group was almost entirely due to an increase in Vti. Sevoflurane and halothane prevented the increase in R(L) and Vti (both P < 0.02) and the decrease in C(L) (both P < 0.02). Conclusions Sevoflurane and halothane can prevent methacholine-induced changes in lung function.

Remote Asynergy Detected by Biplane Transesophageal Echocardiography During Myocardial Revascularization Without Cardiopulmonary Bypass

1991 ◽  
Vol 73 (5) ◽  
pp. 642???645
Author(s):  
Randall M. Schell ◽  
Pratima M. Shah ◽  
Richard L. Applegate ◽  
Pravin M. Shah ◽  
Carlos A. Schmidt
Keyword(s):  
Cardiopulmonary Bypass ◽  
Transesophageal Echocardiography ◽  
Myocardial Revascularization

Comparison between Radionuclide Ejection Fraction and Fractional Area Changes Derived from Transesophageal Echocardiography Using Automated Border Detection

1996 ◽  
Vol 85 (3) ◽  
pp. 468-474. ◽  
Author(s):  
Ngai Liu ◽  
Pierre-Louis Darmon ◽  
Michel Saada ◽  
Patrick Catoire ◽  
Jean Rosso ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Transesophageal Echocardiography ◽  
Detection System ◽  
Systolic Function ◽  
Radionuclide Angiography ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Border Detection ◽  
Ventricular Ejection Fraction ◽  
Fractional Area

Background Left ventricular fractional area changes (FAC) can be derived from transesophageal echocardiography using an automated border detection system. However, FAC has not yet been compared to left ventricular ejection fraction (EF) evaluated by a reference technique. The aim of this study was to correlate transesophageal echocardiography automated FAC to EF derived from radionuclide angiography to obtain a quantifying method of global left ventricular systolic function at the bedside. Methods Ten critically ill patients, whose lungs were mechanically ventilated, were included in this prospective study. Patients were scheduled for radionuclide EF evaluation when at least 75% of the endocardium was clearly visualized on transesophageal echocardiography. Patients with esophageal pathology or cardiac dysrhythmia were excluded. Ejection fraction derived from radionuclide angiography was measured using technetium 99m. Echocardiographic data were obtained using an ultrasound system with automated border capabilities. Simultaneous measurements of left ventricular EF and FAC were obtained for each patient, both before and after starting a dobutamine intravenous infusion to modify left ventricular contractility. Results Mean values for radionuclide EF and transesophageal echocardiography FAC were, respectively: 55% +/- 19% (range 19-89%) and 46% +/- 18% (range 17-80%). Left ventricular EF and FAC were significantly correlated (r = 0.85, SEE = 9.6%). Variations of EF and FAC, induced by dobutamine, were also correlated (r = 0.70, SEE = 4.9%). Conclusions Fractional area changes determined by transesophageal echocardiography using automated border detection correlate well with radionuclide EF and may be used at the bedside to quantify left ventricular function in selected intensive care unit patients.

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