Circulation, Vol 69, 703-710, Copyright © 1984 by American Heart Association
RG McKay, JR Spears, JM Aroesty, DS Baim, HD Royal, GV Heller, W Lincoln, RW Salo, E Braunwald and W Grossman
The feasibility of using continuous on-line recording of intraventricular
electrical impedance to measure ventricular stroke volume was assessed in
12 patients at cardiac catheterization with a multielectrode impedance
catheter and a 1.3 kHz measuring current of 4 microA. Stroke volumes
determined by electrical impedance were compared with stroke volumes
determined by the thermodilution technique in 10 patients and correlated
with an r value of .95. Directional changes in impedance recordings
throughout the cardiac cycle were also compared with volume curves obtained
from six patients by radionuclide ventriculography, and in all instances
the agreement between the two volume recordings was excellent. For all
patients, on-line measurements of impedance showed a beat-by-beat decrease
in stroke volume with the Valsalva maneuver and the administration of amyl
nitrite, as well as an immediate increase in stroke volume in the
contraction following an extra-systolic beat. Similar directional changes
in stroke volume were recorded in both left and right ventricles. Left
ventricular pressure- volume relationships were assessed with simultaneous
left ventricular pressure recordings and volume signals recorded from the
impedance catheter to determine if impedance measurements of volume can be
used clinically. Pressure-volume diagrams were subsequently plotted, and
for all patients these diagrams showed characteristic isovolumetric
contraction and relaxation phases as well as typical ejection and filling
periods. Moreover, beat-by-beat sequential pressure-volume diagrams
constructed for patients during the administration of amyl nitrite revealed
a linear end-systolic pressure-volume relationship.(ABSTRACT TRUNCATED AT
250 WORDS)
ARTICLES
Instantaneous measurement of left and right ventricular stroke volume and pressure-volume relationships with an impedance catheter
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