Circulation, Vol 70, 812-823, Copyright © 1984 by American Heart Association
J Baan, ET van der Velde, HG de Bruin, GJ Smeenk, J Koops, AD van Dijk, D Temmerman, J Senden and B Buis
An eight-electrode conductance catheter previously developed by us and used
to determine stroke volume in dogs was applied in human beings and dogs to
measure absolute left ventricular volume quantitatively. For calibration we
developed the formula V(t) = (1/alpha)(L2/sigma b)G(t) - Vc, where V(t) is
time-varying left ventricular volume, alpha is a dimensionless constant, L
is the electrode separation, sigma b is the conductivity of blood obtained
by a sampling cuvette, and G(t) is the measured conductance within the left
ventricular cavity. Vc is a correction term caused by the parallel
conductance of structures surrounding the cavity and is measured in two
ways. The first method, applicable in the anesthetized animal, consists of
temporary reduction of volume to zero by suction. The second method uses a
transient change in sigma b by injection of a small bolus of hypertonic
saline (dogs) or 10 ml of cold glucose (humans) into the pulmonary artery.
The validity of the formula was previously established for the isolated
postmortem canine heart. The predicted linearity, slope constant alpha, and
accuracy of Vc for the left ventricle in vivo were investigated by
comparing the conductance volume data with results from independent
methods: electromagnetic blood flow measurement for stroke volume and
indicator dilution technique for ejection fraction (dogs), thermal dilution
for cardiac output (12 patients), and single-plane cineventriculography for
V(t) (five patients). In all comparisons, linear regression showed high
correlation (from r = .82 [n = 46] to r = .988 [n = 20]) while alpha, with
one exception, ranged from 0.75 to 1.07 and the error in Vc ranged from
0.5% to 16.5% (mean 7%). After positioning of the catheter, no arrhythmias
were observed. It is concluded that the conductance catheter provides a
reliable and simple method to measure left ventricular volume, giving an
on-line, time- varying signal that is easily calibrated. Together with left
ventricular pressure obtained through the catheter lumen, the instrument
may be used for instantaneous display of pressure-volume loops to
facilitate assessment of left ventricular pump performance.
ARTICLES
Continuous measurement of left ventricular volume in animals and humans by conductance catheter
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