Danton Mark H D, Byrne John G, Hsin Michael, Laurence Rita, Cohn Lawrence H, Aklog Lishan
Cardiac Surgical Research Laboratory, Brigham and Women's Hospital/Harvard Medical School, Boston, USA.
ASAIO J. 2002 Sep-Oct;48(5):514-9. doi: 10.1097/00002480-200209000-00013.
The conductance catheter method for measuring right ventricular (RV) volume changes was assessed in seven excised porcine hearts. A 5-FG conductance catheter was placed within a latex balloon and positioned in the RV cavity of seven freshly excised porcine hearts. Conductance was recorded while saline was withdrawn from the intraventricular balloon in 2 ml decrements. Linear regression analysis of measured conductance versus reference volumes was computed. The effect of left ventricular (LV) filling and catheter length on conductance derived RV volume was also determined. Conductance derived volumes were highly correlated with reference volumes [R2 0.976, standard deviation (SD) 0.035]. The mean gradient of regression was 0.97 (SD 0.10), and it was not significantly affected by LV volume alterations. However, when we analyzed LV filling, a small but significant increase in the y-intercept was observed (LV empty 3.11 ml, SD 1.71; LV full 4.58, SD 2.39; p = 0.008). Introduction of the catheter through either the tricuspid or pulmonary orifices were both effective in ventricular volume measurement. The effect of mismatch between the catheter length and the RV long axis dimension was evaluated by changing the position of the active sensing electrodes along the catheter body. Conductance measurements, obtained from catheters shorter than the long axis of the RV, still maintained a highly linear correlation with real volume, but regression gradients were significantly reduced (long 0.975, SD 0.087; medium 0.787, SD 0.094; small 0.589, SD 0.091; p < 0.001). These results show that a conductance catheter of appropriate length can accurately measure RV volume, despite the complex shape and geometric changes associated with ventricular filling.
在七个离体猪心脏上评估了用于测量右心室(RV)容积变化的电导导管法。将一根5-FG电导导管置于乳胶球囊内,并放置在七个新鲜离体猪心脏的右心室腔中。在以2 ml递减量从心室内球囊中抽出盐水时记录电导。计算测量的电导与参考容积之间的线性回归分析。还确定了左心室(LV)充盈和导管长度对电导得出的右心室容积的影响。电导得出的容积与参考容积高度相关[R2 0.976,标准差(SD)0.035]。回归的平均梯度为0.97(SD 0.10),并且不受左心室容积改变的显著影响。然而,当我们分析左心室充盈时,观察到y轴截距有小幅但显著的增加(左心室空虚时为3.11 ml,SD 1.71;左心室充盈时为4.58,SD 2.39;p = 0.008)。通过三尖瓣或肺动脉口插入导管在心室容积测量中均有效。通过改变有源传感电极沿导管主体的位置来评估导管长度与右心室长轴尺寸不匹配的影响。从比右心室长轴短的导管获得的电导测量值与实际容积仍保持高度线性相关,但回归梯度显著降低(长导管0.975,SD 0.087;中导管0.787,SD 0.094;短导管0.589,SD 0.091;p < 0.001)。这些结果表明,尽管心室充盈会带来复杂的形状和几何变化,但合适长度的电导导管仍可准确测量右心室容积。