Is There a Correlation Between Left Ventricular Outflow Tract Velocity Time Integral and Stroke Volume Index in Patients Undergoing Cardiac Surgery?

Cureus. 2022 Jul 25;14(7):e27257. doi: 10.7759/cureus.27257. eCollection 2022 Jul.

Abstract

Introduction Left ventricular outflow tract velocity time integral (LVOT VTI) is a promising surrogate for stroke volume (SV). However, there is controversy in the literature regarding its correlation with thermodilution or newer cardiac output measurement techniques. This study was conducted to determine the correlation between LVOT VTI determined by transesophageal echocardiography (TEE) with stroke volume index (SVI) calculated by thermodilution. Methods Consecutive patients older than 17 years undergoing elective cardiac surgery with pulmonary artery catheter (PAC) and TEE monitoring between September 2021 and February 2022 were included in this prospective, descriptive, single-center study. LVOT VTI was measured using TEE after induction of anesthesia but before skin incision and at least four hours after initial LVOT VTI measurement. SVI was simultaneously measured using the continuous thermodilution technique with a PAC. The correlation between LVOT VTI and SVI was determined with Pearson's correlation index. Results Twelve patients were included and 21 paired measurements were compared. Mean SVI was 31.62 ± 10.71 mL/m2 and mean LVOT VTI was 14.74 ± 4.79 cm. The Pearson's correlation index for the two measurements was r = 0.257, p = 0.262. Conclusion This prospective study demonstrated a weak correlation between LVOT VTI and SVI in patients undergoing cardiac surgery.

Keywords: left ventricular outflow tract; lvot vti; pulmonary artery catheter; stroke volume index; transesophageal echocardiography (tee); velocity time integral.