慢性动物模型研究中使用实时三维超声心动图定量左心室与右心室每搏输出量差异：采用C扫描定量主动脉瓣反流可改善结果。

Real-time 3-dimensional echocardiography for quantification of the difference in left ventricular versus right ventricular stroke volume in a chronic animal model study: Improved results using C-scans for quantifying aortic regurgitation.

作者信息

Li Xiaokui, Jones Michael, Irvine Timothy, Rusk Rosemary A, Mori Yoshiki, Hashimoto Ikuo, Von Ramm Olaf T, Li Jun, Zetts Arthur, Pemberton James, Sahn David J

机构信息

Clinical Care Center for Congenital Heart Disease, Oregon Health and Science University, Portland, OR 97239, USA.

出版信息

J Am Soc Echocardiogr. 2004 Aug;17(8):870-5. doi: 10.1016/j.echo.2004.04.018.

DOI:10.1016/j.echo.2004.04.018

PMID:15282492

Abstract

OBJECTIVE

The purpose of our study was to test the applicability of calculating the difference between left ventricular (LV) and right ventricular (RV) stroke volume (SV) for assessing the severity of aortic (Ao) regurgitation (AR) using a real-time 3-dimensional (3D) echocardiographic (RT3DE) imaging system.

METHODS

The Ao valve was incised in 5 juvenile sheep, 6 to 10 weeks before the study, to produce AR (mean regurgitant fraction = 0.50). Simultaneous hemodynamic and RT3DE images were obtained on open-chest animals with Ao and pulmonary flows derived by Ao and pulmonary electromagnetic flowmeters balanced against each other. Four stages (baseline, volume loading, sodium nitroprusside, and angiotensin infusion) were used to produce a total of 16 different hemodynamic states. Epicardial scanning was done with a 2.5-MHz probe to sequentially record first the RV and then the LV cavities. Cavity volumes from the 3D echocardiography data were determined from angled sector planes (B-scans) and parallel cutting planes (C-scans, which are planes perpendicular to the direction of the volume interrogation). AR volumes were determined from 3D images by computing and then subtracting RV SVs from LV SVs and then these were compared with electromagnetic flowmeter-derived SV and regurgitant volumes.

RESULTS

There was close correlation between RV and LV SVs of the RT3DE and electromagnetic methods (C-scans: LV, r = 0.98, standard error of the estimate [SEE] = 2.62 mL, P =.0001; RV, r = 0.89, SEE = 2.67 mL, P <.0001; and B-scans: LV, r = 0.95, SEE = 3.55 mL, P =.0001; RV, r = 0.77, SEE = 2.78 mL, P =.0003). Because of the small size of the RV in this model, the correlation was closer for C-scans than B-scans for RV SV. AR volume estimation also showed that C-scan (r = 0.93, SEE = 4.23 mL, P <.0001) had closer correlation than B-scan (r = 0.89, SEE = 4.87 mL, P <.0001). However, B-scan-derived AR fraction showed closer correlation than did C-scan (r = 0.82 vs r = 0.85, respectively).

CONCLUSION

In this animal model, RT3DE imaging had the ability to reliably quantify both LV (B- and C-scans) and RV SVs and to assess the severity of AR.

摘要

目的

我们研究的目的是使用实时三维（3D）超声心动图（RT3DE）成像系统，测试计算左心室（LV）和右心室（RV）每搏输出量（SV）之间的差异，以评估主动脉（Ao）反流（AR）严重程度的适用性。

方法

在5只幼年绵羊中，于研究前6至10周切开Ao瓣以产生AR（平均反流分数=0.50）。在开胸动物身上同时获取血流动力学和RT3DE图像，通过Ao和肺电磁流量计相互平衡获得Ao和肺血流量。使用四个阶段（基线、容量负荷、硝普钠和血管紧张素输注）产生总共16种不同的血流动力学状态。使用2.5MHz探头进行心外膜扫描，依次记录RV腔和LV腔。3D超声心动图数据的腔室容积通过成角度的扇形平面（B扫描）和平行切割平面（C扫描，即垂直于容积询问方向的平面）确定。通过计算LV SV减去RV SV来确定AR容积，然后将这些与电磁流量计得出的SV和反流容积进行比较。

结果

RT3DE和电磁方法测量的RV和LV SV之间存在密切相关性（C扫描：LV，r = 0.98，估计标准误差[SEE]=2.62 mL，P =.0001；RV，r = 0.89，SEE = 2.67 mL，P <.0001；B扫描：LV，r = 0.95，SEE = 3.55 mL，P =.0001；RV，r = 0.77，SEE = 2.78 mL，P =.0003）。由于该模型中RV体积较小，RV SV的C扫描相关性比B扫描更紧密。AR容积估计也显示，C扫描（r = 0.93，SEE = 4.23 mL，P <.0001）比B扫描（r = 0.89，SEE = 4.87 mL，P <.0001）相关性更紧密。然而，B扫描得出的AR分数比C扫描相关性更紧密（分别为r = 0.82和r = 0.85）。