Inter- and intrasubject variability of the thermodilution measurement of right ventricular ejection fraction and volume in patients with chronic obstructive pulmonary disease

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Abstract
Study objective – To determine the spontaneous changes in volumetric indices of right ventricular function assessed by thermodilution. Design – The study involved measurements of inter- and intraindividual variation of right ventricular function in human subjects at rest and at two different levels of low load supine bicycle exercise. Subjects – The subjects were 23 patients with chronic obstructive pulmonary disease, referred for evaluation by right heart catheterisation. Mean (SEM) age was 55.4 (2.2) years and all were in sinus rhythm. Measurements and results – Successive measurements of ejection fraction and right ventricular end diastolic and end systolic volumes were made by thermodilution with a fast response thermistor mounted in a Swan-Ganz catheter. Five measurements were made at rest (R), and three measurements during each of two levels of exercise (E1, E2). Group average values for each period showed no significant changes with time; interindividual variability was expressed as the coefficient of variation (VC1 = SD/ Conclusions – It is important to monitor heart rate before and during thermodilution measurements and to take into account only those made with stable heart rate. Injectate temperature should be above 10°C.

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