Is There a Correlation Between Left Ventricular Outflow Tract Velocity Time Integral and Stroke Volume Index in Patients Undergoing Cardiac Surgery?

Abstract

IntroductionLeft ventricular outflow tract velocity time integral (LVOT VTI) is a promising surrogate for stroke volume (SV). However, there is controversy in the literature regarding its correlation with thermodilution or newer cardiac output measurement techniques. This study was conducted to determine the correlation between LVOT VTI determined by transesophageal echocardiography (TEE) with stroke volume index (SVI) calculated by thermodilution. MethodsConsecutive patients older than 17 years undergoing elective cardiac surgery with pulmonary artery catheter (PAC) and TEE monitoring between September 2021 and February 2022 were included in this prospective, descriptive, single-center study. LVOT VTI was measured using TEE after induction of anesthesia but before skin incision and at least four hours after initial LVOT VTI measurement. SVI was simultaneously measured using the continuous thermodilution technique with a PAC. The correlation between LVOT VTI and SVI was determined with Pearson's correlation index. ResultsTwelve patients were included and 21 paired measurements were compared. Mean SVI was 31.62 ± 10.71 mL/m 2 and mean LVOT VTI was 14.74 ± 4.79 cm. The Pearson's correlation index for the two measurements was r = 0.257, p = 0.262. ConclusionThis prospective study demonstrated a weak correlation between LVOT VTI and SVI in patients undergoing cardiac surgery.

The Utility of Echocardiography in Estimating Fluid Responsiveness

“…Another study that looked at LVOT VTI using TEE, found a weak correlation between using LVOT VTI measured by TEE and SV index calculated using a pulmonary artery catheterization. This study was only done in patients undergoing cardiac surgery [ 17 ]. Factors that influence the accuracy of LVOT VTI are usually in cases with LVOT obstruction [ 16 ].…”