Danton Mark H D, Greil Gerald F, Byrne John G, Hsin Michael, Cohn Lawrence, Maier Stephan E
Department of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Am J Physiol Heart Circ Physiol. 2003 Oct;285(4):H1774-85. doi: 10.1152/ajpheart.00048.2003. Epub 2003 May 22.
Continuous ventricular volume measurement by the conductance method assumes a homogeneous electrical field dispersed throughout and contained within the ventricle. Because of dense trabeculation and complex geometry, right ventricular (RV) volume description by this method may be seriously compromised. This study sought to determine the accuracy and limitations of RV volume measurement by conductance, with magnetic resonance (MR) imaging (MRI) used as a reference, in the porcine RV. Anesthetized pigs (n = 5, 45-55 kg) were placed in a 1.5-T magnet, and ECG-gated transverse MR images (5-mm slices) were acquired during the complete cardiac cycle. RV cavity volumes were subsequently determined by Simpson's technique. Animals were then instrumented with an RV conductance catheter and an ultrasonic pulmonary artery flow probe. Conductance catheter signals were recorded using single- and dual-field (SF and DF) excitation, and the saline-dilution technique was used to correct volumes for parallel conductance. The gain factor (alpha) was calculated as the ratio of conductance- to MRI-derived stroke volume (alpha SV). Variation of alpha during the cardiac cycle was computed by comparing RV conductance volumes with 1) MRI volumes at isochronal time points within the cardiac cycle [alpha(t)] and 2) the pulmonary flow integral during ejection. After calibration, the conductance-MRI volume relation was modeled linearly with good correlation [r = 0.96 (SF) and r = 0.94 (DF)], close to the line of identity. Individual conductance-MRI plots displayed a slight curvilinear relation that was concave toward the MRI axis. Consistent with this finding, alpha(t) varied significantly during the cardiac cycle (0.49 and 0.39 by SF for end systole and end diastole, respectively, P = 0.011). DF excitation resulted in improved volume measurement [alpha SV = 0.41 (SF) and 0.96 (DF)], with less variation in alpha(t) (1.0 and 0.92 by DF for end systole and end diastole, respectively, P = 0.66). These results indicate that, with calibration, the conductance method can measure absolute RV volume under steady-state conditions. However, the curvilinearity and alpha(t) variation would indicate the potential for nonlinearity when RV volumes are varied over a wider range.
通过电导法进行连续心室容积测量假定整个心室内存在均匀分布且局限于心室内的电场。由于右心室存在密集的小梁结构和复杂的几何形状,用这种方法描述右心室(RV)容积可能会受到严重影响。本研究旨在以磁共振(MR)成像(MRI)作为参考,确定电导法测量猪右心室容积的准确性和局限性。将麻醉后的猪(n = 5,体重45 - 55 kg)置于1.5 T的磁体中,在整个心动周期内采集心电图门控的横向MR图像(层厚5 mm)。随后采用Simpson法测定右心室腔容积。然后给动物植入右心室电导导管和超声肺动脉血流探头。使用单场和双场(SF和DF)激励记录电导导管信号,并采用盐水稀释技术校正平行电导的容积。增益因子(α)计算为电导法与MRI法测得的每搏量之比(αSV)。通过比较右心室电导容积与以下两者来计算心动周期中α的变化:1)心动周期内等时时间点的MRI容积[α(t)];2)射血期的肺血流积分。校准后,电导 - MRI容积关系呈线性模型,相关性良好[r = 0.96(SF)和r = 0.94(DF)],接近恒等线。个体电导 - MRI曲线显示出轻微的曲线关系,向MRI轴凹陷。与此发现一致,α(t)在心动周期中变化显著(收缩末期和舒张末期SF法分别为0.49和0.39,P = 0.011)。DF激励改善了容积测量[αSV = 0.41(SF)和0.96(DF)],α(t)的变化较小(收缩末期和舒张末期DF法分别为1.0和0.92,P = 0.66)。这些结果表明,经过校准后,电导法能够在稳态条件下测量右心室绝对容积。然而,曲线性和α(t)的变化表明,当右心室容积在更宽范围内变化时,可能存在非线性情况。