Inter- and intrasubject variability of the thermodilution measurement of right ventricular ejection fraction and volume in patients with chronic obstructive pulmonary disease. 1990

F Schrijen, and A Henriquez, and J Renondo, and F Poincelot, and M Pichene
INSERM Unité 14, Vandoeuvre-les-Nancy, France.

OBJECTIVE To determine the spontaneous changes in volumetric indices of right ventricular function assessed by thermodilution. METHODS The study involved measurements of inter- and intraindividual variation of right ventricular function in human subjects at rest and at two different levels of low load supine bicycle exercise. METHODS The subjects were 23 patients with chronic obstructive pulmonary disease, referred for evaluation by right heart catheterisation. Mean (SEM) age was 55.4 (2.2) years and all were in sinus rhythm. RESULTS Successive measurements of ejection fraction and right ventricular end diastolic and end systolic volumes were made by thermodilution with a fast response thermistor mounted in a Swan-Ganz catheter. Five measurements were made at rest (R), and three measurements during each of two levels of exercise (E1, E2). Group average values for each period showed no significant changes with time; interindividual variability was expressed as the coefficient of variation (VC1 = SD/means), intraindividual variability (VC2) as square root of mean value of individual variances. Interindividual variability increased from rest to exercise, while intraindividual variability was lower during exercise, presumably because the variables were more steady. For ejection fraction, VC1, was 23% at rest, 29% for E1 and 32% for E2, while VC2 was 21%, 12% and 15% respectively; for right ventricular end diastolic volume, VC1 was 23% at rest, 29% and 28% during exercise, and VC2 was 17%, 12% and 11% respectively. In some patients cold injection induced bradycardia and spuriously high values of ejection fraction. CONCLUSIONS - It is important to monitor heart rate before and during thermodilution measurements and to take into account only those made with stable heart rate. Injectate temperature should be above 10 degrees C.

UI MeSH Term Description Entries
D008173 Lung Diseases, Obstructive Any disorder marked by obstruction of conducting airways of the lung. AIRWAY OBSTRUCTION may be acute, chronic, intermittent, or persistent. Obstructive Lung Diseases,Obstructive Pulmonary Diseases,Lung Disease, Obstructive,Obstructive Lung Disease,Obstructive Pulmonary Disease,Pulmonary Disease, Obstructive,Pulmonary Diseases, Obstructive
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003080 Cold Temperature An absence of warmth or heat or a temperature notably below an accustomed norm. Cold,Cold Temperatures,Temperature, Cold,Temperatures, Cold
D005080 Exercise Test Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. Arm Ergometry Test,Bicycle Ergometry Test,Cardiopulmonary Exercise Testing,Exercise Testing,Step Test,Stress Test,Treadmill Test,Cardiopulmonary Exercise Test,EuroFit Tests,Eurofit Test Battery,European Fitness Testing Battery,Fitness Testing,Physical Fitness Testing,Arm Ergometry Tests,Bicycle Ergometry Tests,Cardiopulmonary Exercise Tests,Ergometry Test, Arm,Ergometry Test, Bicycle,Ergometry Tests, Arm,Ergometry Tests, Bicycle,EuroFit Test,Eurofit Test Batteries,Exercise Test, Cardiopulmonary,Exercise Testing, Cardiopulmonary,Exercise Tests,Exercise Tests, Cardiopulmonary,Fitness Testing, Physical,Fitness Testings,Step Tests,Stress Tests,Test Battery, Eurofit,Test, Arm Ergometry,Test, Bicycle Ergometry,Test, Cardiopulmonary Exercise,Test, EuroFit,Test, Exercise,Test, Step,Test, Stress,Test, Treadmill,Testing, Cardiopulmonary Exercise,Testing, Exercise,Testing, Fitness,Testing, Physical Fitness,Tests, Arm Ergometry,Tests, Bicycle Ergometry,Tests, Cardiopulmonary Exercise,Tests, EuroFit,Tests, Exercise,Tests, Step,Tests, Stress,Tests, Treadmill,Treadmill Tests
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013318 Stroke Volume The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume. Ventricular Ejection Fraction,Ventricular End-Diastolic Volume,Ventricular End-Systolic Volume,Ejection Fraction, Ventricular,Ejection Fractions, Ventricular,End-Diastolic Volume, Ventricular,End-Diastolic Volumes, Ventricular,End-Systolic Volume, Ventricular,End-Systolic Volumes, Ventricular,Fraction, Ventricular Ejection,Fractions, Ventricular Ejection,Stroke Volumes,Ventricular Ejection Fractions,Ventricular End Diastolic Volume,Ventricular End Systolic Volume,Ventricular End-Diastolic Volumes,Ventricular End-Systolic Volumes,Volume, Stroke,Volume, Ventricular End-Diastolic,Volume, Ventricular End-Systolic,Volumes, Stroke,Volumes, Ventricular End-Diastolic,Volumes, Ventricular End-Systolic
D013815 Thermodilution Measurement of blood flow based on induction at one point of the circulation of a known change in the intravascular heat content of flowing blood and detection of the resultant change in temperature at a point downstream. Thermodilutions

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