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European Journal of Heart Failure 2006 8(2):136-140; doi:10.1016/j.ejheart.2005.06.006
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© 2006 European Society of Cardiology

Non-invasive measurement of cardiac output by whole-body bio-impedance during dobutamine stress echocardiography: Clinical implications in patients with left ventricular dysfunction and ischaemia

Marina Leitmana, Edgar Suchera, Edo Kaluskia, Ruth Wolfa, Eli Pelega, Yaron Moshkovitzb, Olga Milo-Cottera, Zvi Vereda and Gad Cotterc,*

a Cardiology Department, Assaf-Harofeh Medical Center Israel
b Cardiac Surgical Department, Ramat-Marpe-Assuta Medical Center, Petah Tikva, Sackler School of Medicine, Tel-Aviv University Israel
c Duke Clinical Research Institute PO Box 17969, Durham NC, 27715, USA

* Corresponding author. Duke Clinical Research Institute, 2400 Pratt Street, Durham, 27715 NC, USA. E-mail address: cotte013{at}mc.duke.edu


  Abstract

Objectives: To compare non-invasive determination of cardiac index (CI) by whole body electrical bioimpedance using the NICaS apparatus and Doppler echocardiography, and the role of cardiac power index (Cpi) and total peripheral resistance index (TPRi) calculation during dobutamine stress echocardiography (DSE).

Subjects and methods: We enrolled 60 consecutive patients undergoing DSE. Patients were prospectively divided into 3 groups: Group 1 (n=20): normal DSE (control). Group 2 (n=20): EF<40% without significant ischaemia. Group 3 (n=20): patients with significant ischaemia on DSE. Measurements of CI were performed at the end of each stage of DSE by both echocardiographic left ventricular outflow track flow and the NICaS apparatus, using whole-body bio-impedance. MAP was measured simultaneously and TPRi and Cpi were calculated.

Results: The correlation between non-invasive CI as determined by NICaS and echocardiography was 0.81, although Echocardiographic readings of CI were higher during administration of higher doses of dobutamine. Lower EF correlated with lower Cpi, especially stress induced Cpi. Hence, patients with reduced EF (group 2) had a blunted increase in Cpi during stress. Patients with ischaemia (group 3) had a blunted increase in Cpi as well as a decrease in Cpi and increase in TPRi during the last stages of DSE.

Conclusion: Measurement of CI by NICaS correlated well with Doppler derived CI. The calculation of Cpi and TPRi changes during dobutamine stress may provide important clinical information.

Key Words: Cardiac index • Cardiac power • Bioimpedance

Received December 20, 2004; Accepted June 30, 2005


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