CLINICAL RELIABILITY OF FOUR CURRENTLY AVAILABLE METHODS FOR DETERMINATION OF CARDIAC OUTPUT:COMPARISONS BETWEEN THERMODILUTION, EARPIECE DYE-DILUTION, ECHOCARDIOGRAPHY AND IMPEDANCE CARDIOGRAPHY
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In order to determine the clinical reliability of currently available methods for determination of cardiac output, comparisons were made between the values obtained by thermodilution, earpiece dye-dilution, echocardiography and impedance cardiography in 46 cardiac patients. The case materials consisted of 2 cases of ischemic heart disease, 17 cases of idiopathic cardiomyopathy, 20 cases of rheumatic valvular disease, 5 cases of conduction disturbance, 1 case of myocarditis and 1 case of acute pericarditis.<BR>There was a good agreement between the values obtained by earpiece dye-dilution and those by thermodilution, especially when the cases with valvular diseases were excluded. Among the cases other than valvular disease, the regression equation was Y =0.99X-0.1 (r = +0.83, p <0.01), where X and Y represent the values by tehrmodilution and earpiece dye-dilution, respectively.<BR>The cardiac output calculated from the echocardiographic measurements were also closely correlated with the values obtained by thermodilution, when the cases with regurgitant flow and/or atrial fibrillation were excluded. The regression equation was Y =0.98X +0.5 (r = +0.82, p < 0.01), where X and Y represent the values by thermodilution and echocardiography, respectively.<BR>Although the previous reports indicated that the impedance cardiography might be a reliable method for the determination of cardiac output, the present study failed to demonstrate a good correlation between the values obtained by this method and those by thermodilution or earpiece dye-dilution.<BR>From the above observations we think that both the thermodilution and earpiece dye-dilution are clinically reliable methods for the determination of cardiac output, while the echocardiographic measurements may also give reasonable values in the absence of regurgitant flow, shunt and/or arrhythmias. On the other hand, the absolute values of cardiac output based on the impedance cardiography are clinically unreliable.
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