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Comparison of electrical velocimetry and cardiac magnetic resonance imaging for the non-invasive determination of cardiac output

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Abstract

A novel algorithm of impedance cardiography referred to as electrical velocimetry (EV) has been introduced for non-invasive determination of cardiac output (CO). Previous validation studies yielded diverging results and no comparison with the non-invasive gold standard cardiac magnetic resonance imaging (CMR) has been performed. We therefore aimed to prospectively assess the accuracy and reproducibility of EV compared to CMR. 152 consecutive stable patients undergoing CMR were enrolled. EV measurements were taken twice before or after CMR in supine position and averaged over 20 s (AESCULON®, Osypka Medical, Berlin, Germany). Bland–Altman analysis showed insufficient agreement of EV and CMR with a mean bias of 1.2 ± 1.4 l/min (bias 23 ± 26 %, percentage error 51 %). Reproducibility was high with 0.0 ± 0.3 l/min (bias 0 ± 8 %, percentage error 15 %). Outlier analysis revealed gender, height, CO and stroke volume (SV) by CMR as independent predictors for larger variation. Stratification of COCMR in quintiles demonstrated a good agreement for low values (<4.4 l/min) with bias increasing significantly with quintile as high as 3.1 ± 1.1 l/min (p < 0.001). Reproducibility was not affected (p = 0.71). Subgroup analysis in patients with arrhythmias (p = 0.19), changes in thoracic fluid content (p = 0.51) or left heart failure (p = 0.47) could not detect significant differences in accuracy. EV showed insufficient agreement with CMR and good reproducibility. Gender, height and increasing CO and SV were associated with increased bias while not affecting reproducibility. Therefore, absolute values should not be used interchangeably in clinical routine. EV yet may find its place for clinical application with further investigation on its trending ability pending.

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Authors and Affiliations

  1. 1st Department of Medicine (Cardiology, Angiology, Pneumology, Intensive Care), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Frederik Trinkmann, Manuel Berger, Christina Doesch, Theano Papavassiliu, Martin Borggrefe, Jens J. Kaden & Joachim Saur

  2. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Stefan O. Schoenberg

  3. DZHK (German Center for Cardiovascular Research) Partner Site, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Christina Doesch, Theano Papavassiliu, Stefan O. Schoenberg & Martin Borggrefe

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  1. Frederik Trinkmann
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  2. Manuel Berger
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Correspondence to Joachim Saur.

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Ethical statement

The study protocol was approved by the institutional Ethics Committee and conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from all participants.

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Trinkmann, F., Berger, M., Doesch, C. et al. Comparison of electrical velocimetry and cardiac magnetic resonance imaging for the non-invasive determination of cardiac output. J Clin Monit Comput 30, 399–408 (2016). https://doi.org/10.1007/s10877-015-9731-6

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  • DOI: https://doi.org/10.1007/s10877-015-9731-6

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