Issac Cheong, Pablo Martín Merlo, Francisco Marcelo Tamagnone
{"title":"利用新技术实现颈动脉血流校正时间与左心室流出道速度-时间积分之间的相关性","authors":"Issac Cheong, Pablo Martín Merlo, Francisco Marcelo Tamagnone","doi":"10.1002/jcu.23838","DOIUrl":null,"url":null,"abstract":"BackgroundTransthoracic echocardiography (TTE) is widely used for assessing patients in the intensive care unit, with cardiac output measurement being crucial for hemodynamic monitoring. This is achieved by measuring the velocity‐time integral (VTI) of the left ventricular outflow tract (LVOT), which serves as a surrogate of stroke volume. However, conducting TTE in the critical care setting presents several challenges. Our primary objective was to investigate the relationship between carotid corrected flow time (cCFT) and LVOT VTI. Additionally, we aimed to determine the threshold cCFT value that reliably predicts a normal LVOT VTI.Materials and MethodsThis proof‐of‐concept study involves a post‐hoc analysis from a diagnostic accuracy investigation conducted in a medical‐surgical intensive care unit. We included patients admitted to the ICU from December 2021 to January 2022. We used a phased array transducer to measure the cCFT at the left supraclavicular fossa and the LVOT VTI in an apical 5‐chamber view.ResultsWe included 22 patients. The Spearman coefficient between LVOT VTI and cCFT was 0.82 (<jats:italic>p</jats:italic> < 0.0001). The area under the ROC curve for cCFT to predict LVOT VTI equal to or greater than 17 cm was 0.871 (95% CI 0.660–0.974). A cCFT exceeding 283 ms predicted LVOT VTI equal to or greater than 17 cm with a sensitivity of 93.3% (95% CI 68.1% to 99.8%) and specificity of 85.7% (95% CI 42.1% to 99.6%).ConclusionThe cCFT, measured using a novel technique with a phased array transducer, shows a strong correlation with LVOT VTI. Additionally, cCFT predicts a normal LVOT VTI with good sensitivity and specificity in critically ill patients. Larger studies are warranted to validate these findings.","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlation between corrected carotid flow time and left ventricular outflow tract velocity‐time integral using a novel technique\",\"authors\":\"Issac Cheong, Pablo Martín Merlo, Francisco Marcelo Tamagnone\",\"doi\":\"10.1002/jcu.23838\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BackgroundTransthoracic echocardiography (TTE) is widely used for assessing patients in the intensive care unit, with cardiac output measurement being crucial for hemodynamic monitoring. This is achieved by measuring the velocity‐time integral (VTI) of the left ventricular outflow tract (LVOT), which serves as a surrogate of stroke volume. However, conducting TTE in the critical care setting presents several challenges. Our primary objective was to investigate the relationship between carotid corrected flow time (cCFT) and LVOT VTI. Additionally, we aimed to determine the threshold cCFT value that reliably predicts a normal LVOT VTI.Materials and MethodsThis proof‐of‐concept study involves a post‐hoc analysis from a diagnostic accuracy investigation conducted in a medical‐surgical intensive care unit. We included patients admitted to the ICU from December 2021 to January 2022. We used a phased array transducer to measure the cCFT at the left supraclavicular fossa and the LVOT VTI in an apical 5‐chamber view.ResultsWe included 22 patients. The Spearman coefficient between LVOT VTI and cCFT was 0.82 (<jats:italic>p</jats:italic> < 0.0001). The area under the ROC curve for cCFT to predict LVOT VTI equal to or greater than 17 cm was 0.871 (95% CI 0.660–0.974). A cCFT exceeding 283 ms predicted LVOT VTI equal to or greater than 17 cm with a sensitivity of 93.3% (95% CI 68.1% to 99.8%) and specificity of 85.7% (95% CI 42.1% to 99.6%).ConclusionThe cCFT, measured using a novel technique with a phased array transducer, shows a strong correlation with LVOT VTI. Additionally, cCFT predicts a normal LVOT VTI with good sensitivity and specificity in critically ill patients. Larger studies are warranted to validate these findings.\",\"PeriodicalId\":15386,\"journal\":{\"name\":\"Journal of Clinical Ultrasound\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Ultrasound\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jcu.23838\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ACOUSTICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jcu.23838","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ACOUSTICS","Score":null,"Total":0}
Correlation between corrected carotid flow time and left ventricular outflow tract velocity‐time integral using a novel technique
BackgroundTransthoracic echocardiography (TTE) is widely used for assessing patients in the intensive care unit, with cardiac output measurement being crucial for hemodynamic monitoring. This is achieved by measuring the velocity‐time integral (VTI) of the left ventricular outflow tract (LVOT), which serves as a surrogate of stroke volume. However, conducting TTE in the critical care setting presents several challenges. Our primary objective was to investigate the relationship between carotid corrected flow time (cCFT) and LVOT VTI. Additionally, we aimed to determine the threshold cCFT value that reliably predicts a normal LVOT VTI.Materials and MethodsThis proof‐of‐concept study involves a post‐hoc analysis from a diagnostic accuracy investigation conducted in a medical‐surgical intensive care unit. We included patients admitted to the ICU from December 2021 to January 2022. We used a phased array transducer to measure the cCFT at the left supraclavicular fossa and the LVOT VTI in an apical 5‐chamber view.ResultsWe included 22 patients. The Spearman coefficient between LVOT VTI and cCFT was 0.82 (p < 0.0001). The area under the ROC curve for cCFT to predict LVOT VTI equal to or greater than 17 cm was 0.871 (95% CI 0.660–0.974). A cCFT exceeding 283 ms predicted LVOT VTI equal to or greater than 17 cm with a sensitivity of 93.3% (95% CI 68.1% to 99.8%) and specificity of 85.7% (95% CI 42.1% to 99.6%).ConclusionThe cCFT, measured using a novel technique with a phased array transducer, shows a strong correlation with LVOT VTI. Additionally, cCFT predicts a normal LVOT VTI with good sensitivity and specificity in critically ill patients. Larger studies are warranted to validate these findings.
期刊介绍:
The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography.
The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents.
JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.