Abstract

FLORIO, Lucía; CENTURION, Raúl; VIGNOLO, Gustavo  and  POUSO, Jorge. Reproducibilidad de la estimación de índice cardíaco y resistencias vasculares sistémicas por eco-Doppler en pacientes con insuficiencia cardíaca crónica. Rev.Urug.Cardiol. [online]. 2009, vol.24, n.3, pp.164-170. ISSN 1688-0420.

Background: systemic vascular resistance (SVR) and cardiac index (CI) estimation by Doppler echcocardiography have a good correlation with invasive estimations and a good reproducibility. There are few reports about these echocardiographic estimations in chronic heart failure. Aim: to determine intra and interobserver variability of systemic vascular resistance and cardiac index estimation for the echocardiographic team of an ambulatory heart failure care unit. Method: direct echocardiographic variables were: outflow tract (OFT)diameter, OFT velocity-time integral (VTI) , right atrial pressure (RAP) estimated through inferior cave vein diameter and respiration variation. Cardiac frequency, arterial presssure and middle arterial pressure (MAP) were registered. To calculate CI, cardiac output (CO) and SVR next formulas were applied: CI: CO/ body surface area, CO: (OFT-VTI . OFT area). cardiac frequency, SVR: (MAP-RAP) /CO. Intraobserver variability (direct and calculated variables) was determine through a unique observer who made 5 consecutive observation (15 minutes separated each one) in 5 different patients. Kappa index was calculated for inter observer reproducibility by 2 observers level 3 who took direct and calculated variables in 12 consecutive patients. All observations were done in sinus rythm. Results: intraobserver variability was 5,7% for direct echocardiographic variables and 13,6% for calculated ones (acceptable). Ponderated kappa index for interobserver reproducibility was 0,87 (very good). Conclusion: our echocardiographic team show acceptable intra and inter observer reproducibility for CI and SVR estimation by Doppler echocardiography in chronic heart failure patients

Keywords : ECHOCARDIOGRAPHY; CARDIAC INDEX;  SYSTEMIC VASCULAR RESISTANCE;  HEART FAILURE; REPRODUCIBILITY.

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