Left Ventricular Stroke Volume Quantification by Contrast Echocardiography – Comparison of Linear and Flow‐Based Methods to Cardiac Magnetic Resonance

Abstract

Background Echocardiography (echo) quantified LV stroke volume (SV) is widely used to assess systolic performance after acute myocardial infarction (AMI). This study compared two common echo approaches – predicated on flow (Doppler) and linear chamber dimensions (Teichholz) – to volumetric SV and global infarct parameters quantified by cardiac magnetic resonance (CMR). Methods Multimodality imaging was performed as part of a post-AMI registry. For echo, SV was measured by Doppler and Teichholz methods. Cine-CMR was used for volumetric SV and LVEF quantification, and delayed-enhancement CMR for infarct size. Results 142 patients underwent same-day echo and CMR. On echo, mean SV by Teichholz (78±17ml) was slightly higher than Doppler (75±16ml; Δ=3±13ml, p=0.02). Compared to SV on CMR (78±18ml), mean difference by Teichholz (Δ=−0.2±14; p=0.89) was slightly smaller than Doppler (Δ−3±14; p=0.02) but limits of agreement were similar between CMR and echo methods (Teichholz: −28, 27 ml, Doppler: −31, 24ml). For Teichholz, differences with CMR SV were greatest among patients with anteroseptal or lateral wall hypokinesis (p<0.05). For Doppler, differences were associated with aortic valve abnormalities or root dilation (p=0.01). SV by both echo methods decreased stepwise in relation to global LV injury as assessed by CMR-quantified LVEF and infarct size (p<0.01). Conclusions Teichholz and Doppler calculated SV yield similar magnitude of agreement with CMR. Teichholz differences with CMR increase with septal or lateral wall contractile dysfunction, whereas Doppler yields increased offsets in patients with aortic remodeling.

Effect of coronary artery bypass grafting on blood pressure response to head-up tilting

“…Therefore, we analyzed the echo data of 8 patients and 7 healthy subjects. Stroke volume (SV) and left ventricle ejection fraction (EF) were calculated by the method established previously [23,24], at baseline, 1st and 15th min during HUT (HUT1 and HUT15, respectively), after assessing left ventricle end-diastolic (LVEDV) and end-systolic volumes (LVESV) by echocardiography. Cardiac output (CO) was calculated as SV multiplied by HR.…”

Centile Curves for Velocity-Time Integral Times Heart Rate as a Function of Ventricular Length: The Use of Minute Distance Is Advantageous to Enhance Clinical Reliability in Children

“…This becomes apparent when using either biplanar quantification of areas or methods including the integration of Doppler waveforms and the determination of crosssectional areas, because these measurements rely strongly on calculations based on formulas and anatomic assumptions that do not reflect real cardiac anatomy or flow conditions. [6][7][8][9] The measurement of Doppler waveforms across great vessels is carried out by every cardiologist for the estimation of velocities and gradients; this technique is highly reproducible. 10,11 Furthermore, it has been shown that measurements of the velocity-time integral (VTI) improve CO estimation as it is ''a linear analogue'' of SV, 12 or at least proportional to SV.…”

Independent Effect of Low Flow on Outcomes in Patients Undergoing Aortic Valve Replacement for Severe Aortic Stenosis

“…Echocardiography is widely used to assess cardiac function and can measure the stroke volume by several methods. 21 One common approach uses a volumetric method based on the Teichholz formula, which was used in the present study. Pitfalls of the Teichholz method include off-axis left ventricular measurement, concomitant mitral valve regurgitation or aortic valve regurgitation, and discordance between regional and global left ventricular systolic function, which can often occur in patients with severe coronary artery disease.…”