The Utility of 3D Left Atrial Volume and Mitral Flow Velocities as Guides for Acute Volume Resuscitation

Left ventricular end-diastolic pressure (LVEDP) is the foundation of cardiac function assessment. Because of difficulties and risks associated with its direct measurement, correlates of LVEDP derived by pulmonary artery (PA) catheterization or transesophageal echocardiography (TEE) are commonly adop...

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Bibliographic Details
Published in:BioMed research international 2015-01, Vol.2015 (2015), p.1-6
Main Authors: Santosa, Claudia M., Fleming, Neal W., Rose, David D.
Format: Article
Language:English
Subjects:
Aged
Blood flow
Blood Flow Velocity
Cardiology
Clinical Study
Echocardiography, Transesophageal
Female
Flow velocity
Fluid therapy
Health aspects
Heart Atria - diagnostic imaging
Heart Atria - physiopathology
Heart atrium
Humans
Male
Measurement
Methods
Middle Aged
Mitral valve
Mitral Valve - diagnostic imaging
Mitral Valve - physiopathology
Patients
Physiological aspects
Resuscitation
Software
Studies
Ventricular Function, Left
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Summary:Left ventricular end-diastolic pressure (LVEDP) is the foundation of cardiac function assessment. Because of difficulties and risks associated with its direct measurement, correlates of LVEDP derived by pulmonary artery (PA) catheterization or transesophageal echocardiography (TEE) are commonly adopted. TEE has the advantage of being less invasive; however TEE-based estimation of LVEDP using correlates such as left ventricular end-diastolic volume (LVEDV) has technical difficulties that limit its clinical usefulness. Using intraoperative acute normovolemic hemodilution (ANH) as a controlled hemorrhagic model, we examined various mitral flow parameters and three-dimensional reconstructions of left atrial volume as surrogates of LVEDP. Our results demonstrate that peak E wave velocity and left atrial end-diastolic volume (LAEDV) correlated with known changes in intravascular volume associated with ANH. Although left atrial volumetric analysis was done offline in our study, recent advances in echocardiographic software may allow for continuous display and real-time calculation of LAEDV. Along with the ease and reproducibility of acquiring Doppler images of flow across the mitral valve, these two correlates of LVEDP may justify a more widespread use of TEE to optimize intraoperative fluid management. The clinical applicability of peak E wave velocity and LAEDV still needs to be validated during uncontrolled resuscitation.
ISSN:2314-6133
2314-6141
DOI:10.1155/2015/697327