Continuous measurement of left ventricular volume in animals and humans by conductance catheter.

TLDR

The conductance formula’s validity had been previously confirmed in isolated postmortem canine hearts. The study applied an eight‑electrode conductance catheter to humans and dogs to quantitatively measure absolute left‑ventricular volume. Calibration used the formula V(t)= (1/α)(L²/σ_b b)G(t)–Vc, with Vc determined by suction‑induced zero volume or hypertonic saline/cold glucose injections, and conductance data were compared to electromagnetic flow, indicator dilution, thermal dilution, and cineventriculography. Linear regression against independent methods yielded r = 0.82–0.988, α = 0.75–1.07, mean Vc error 7 %, with no arrhythmias, confirming the catheter as a reliable, simple, real‑time left‑ventricular volume measurement tool that can display pressure‑volume loops.

Abstract

An eight-electrode conductance catheter previously developed by us and used to determine stroke volume in dogs was applied in human beings and dogs to measure absolute left ventricular volume quantitatively. For calibration we developed the formula V(t) = (1/alpha)(L2/sigma b)G(t) - Vc, where V(t) is time-varying left ventricular volume, alpha is a dimensionless constant, L is the electrode separation, sigma b is the conductivity of blood obtained by a sampling cuvette, and G(t) is the measured conductance within the left ventricular cavity. Vc is a correction term caused by the parallel conductance of structures surrounding the cavity and is measured in two ways. The first method, applicable in the anesthetized animal, consists of temporary reduction of volume to zero by suction. The second method uses a transient change in sigma b by injection of a small bolus of hypertonic saline (dogs) or 10 ml of cold glucose (humans) into the pulmonary artery. The validity of the formula was previously established for the isolated postmortem canine heart. The predicted linearity, slope constant alpha, and accuracy of Vc for the left ventricle in vivo were investigated by comparing the conductance volume data with results from independent methods: electromagnetic blood flow measurement for stroke volume and indicator dilution technique for ejection fraction (dogs), thermal dilution for cardiac output (12 patients), and single-plane cineventriculography for V(t) (five patients). In all comparisons, linear regression showed high correlation (from r = .82 [n = 46] to r = .988 [n = 20]) while alpha, with one exception, ranged from 0.75 to 1.07 and the error in Vc ranged from 0.5% to 16.5% (mean 7%). After positioning of the catheter, no arrhythmias were observed. It is concluded that the conductance catheter provides a reliable and simple method to measure left ventricular volume, giving an on-line, time-varying signal that is easily calibrated. Together with left ventricular pressure obtained through the catheter lumen, the instrument may be used for instantaneous display of pressure-volume loops to facilitate assessment of left ventricular pump performance.