Morrison D A, Stovall R, Sensecqua J, Friefeld G
Cathet Cardiovasc Diagn. 1987 May-Jun;13(3):167-73. doi: 10.1002/ccd.1810130305.
This study addressed the clinical reproducibility and validity of the thermodilution (TD) measurement of the right ventricular ejection fraction (RVEF). Forty-one patients underwent right heart catheterization, including TD RVEF, within 2 h of gated first pass (GFP) and gated blood pool (GBP) radionuclide ventriculography; 21 had single plane contrast right ventricular angiography (ANGIO) during the same catheterization. Analysis of variance showed no difference among three successive TD RVEF measurements. (table; see text) Stroke volume by RV ANGIO correlated with Fick (n = 10, r = .86) and thermodilution stroke volume (n = 21, r = .88). It is concluded that although the thermodilution method is an accurate way to measure flow, it is not an accurate way to measure right ventricular ejection fraction, and by inference, ventricular volumes. The most likely explanation for this finding is incomplete mixing as in previous studies of indicator methods of measuring left ventricular volumes.
本研究探讨了热稀释法(TD)测量右心室射血分数(RVEF)的临床可重复性和有效性。41例患者在首次通过门控(GFP)和门控血池(GBP)放射性核素心室造影后2小时内接受了右心导管检查,包括TD RVEF测量;其中21例在同一导管检查期间进行了单平面对比右心室血管造影(ANGIO)。方差分析显示,连续三次TD RVEF测量之间无差异。(表格;见正文)右心室血管造影测得的每搏输出量与菲克法(n = 10,r = 0.86)和热稀释法测得的每搏输出量(n = 21,r = 0.88)相关。研究得出结论,尽管热稀释法是测量血流量的准确方法,但不是测量右心室射血分数的准确方法,由此推断,也不是测量心室容积的准确方法。这一发现最可能的解释是,如同以往测量左心室容积的指示剂法研究一样,存在混合不充分的情况。