Doppler two-dimensional echocardiographic determinations of right ventricular output and diastolic filling.

Two methods of measuring right ventricular cardiac output with pulsed Doppler two-dimensional echocardiography were developed in 29 patients who underwent cardiac catheterization and angiography. Using tricuspid inflow and main pulmonary artery outflow methods we determined cardiac output, and good correlations were observed between thermodilution and Doppler measurements (r = 0.93 and 0.89, respectively). Results by the two methods correlated closely in patients without regurgitant lesions. In patients with tricuspid regurgitation, right ventricular inflow was always greater than right ventricular outflow volume while the reverse was true in those with pulmonary insufficiency. Furthermore, we investigated the right ventricular peak filling rate as the Doppler peak diastolic velocity X cross-sectional area of the tricuspid annulus and half filling right ventricular fraction derived from the time velocity integral of the Doppler-determined velocity curve. For the tricuspid valve morphologically, the Doppler-derived velocity profile in diastole resembled the first derivative of the angiographic right ventricular volume curve. A significant correlation was observed between the Doppler echocardiographic and angiographic peak filling rate (r = 0.84). The results of the present study validate the use of Doppler two-dimensional quantitative measurements of the right ventricular output, regurgitant fraction and indexes of diastolic function.