Abstract
Monitoring cardiac output (CO) is helpful in the perioperative management of the patient with severe mitral regurgitation (MR). We assessed the accuracy and precision of the Cheetah CO monitor in patients with moderate or severe MR undergoing right and left heart catheterization as part of their pre-operative evaluation for mitral valve surgery. Cheetah CO was obtained concurrently with thermodilution CO (TD CO). Bias data was non-normally distributed; therefore, a non-parametric equivalent to Bland and Altman limits of agreement was used. Additionally, the proportions of differences between the experimental and reference method that were ≤ 0.5 L/min, ≤ 1 L/min, and >1 L/min were calculated. Twenty-seven subjects were enrolled and completed the study. The median difference between Cheetah and TD CO measurements was − 0.82 L/min, and the 5th and 95th centiles were − 6.05 L/min and 3.25 L/min, respectively. Of all differences, 25.9%, 51.9%, and 48.1% were ≤ 0.5 L/min, ≤ 1 L/min, and > 1 L/min. No proportional bias was present. We conclude that the Cheetah CO measurements in patients with moderate to severe MR cannot be used interchangeably with TD CO due to a large bias and imprecision.
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The complete dataset is available from the Figshare public repository at [https://doi.org/10.6084/m9.figshare.30099667].
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Acknowledgements
We acknowledge Brian McEniry, CRC, for his outstanding contributions to the data collection and management of this study.
Funding
This was an investigator-initiated study supported by an unrestricted research grant by Baxter Healthcare Corporation Inc., Deerfield, IL, USA, awarded to Cooper University Healthcare. In addition, Baxter supplied the Cheetah monitor sensors necessary for the measurements. The funder was not involved in the conduct of the research, data interpretation, manuscript drafting, or the decision to publish.
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L.M. and N.v.H. participated in study conception, design, data analysis and manuscript preparation. N.v.H. prepared all figures and tables. L.M., M.R., G.K., A.A., J.A., J.O. and K.T. participated in enrolment, data collection and manuscript editing.
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Mitrev, L., Rosenbloom, M., Kaddissi, G. et al. A validation study comparing cheetah monitor cardiac output to thermodilution cardiac output in patients with severe mitral regurgitation. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37478-y
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DOI: https://doi.org/10.1038/s41598-026-37478-y
