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猪心肌梗死后肺血容量变化减少:心力衰竭的定量和无创性磁共振成像测量方法。

Pulmonary blood volume variation decreases after myocardial infarction in pigs: a quantitative and noninvasive MR imaging measure of heart failure.

机构信息

Cardiac MR Group, Department of Radiology and Physiology, Skåne University Hospital, Lund University, Getingevagen, SE-22185 Lund, Sweden.

出版信息

Radiology. 2010 Aug;256(2):415-23. doi: 10.1148/radiol.10090292.

DOI:10.1148/radiol.10090292
PMID:20656833
Abstract

PURPOSE

To prospectively evaluate the usefulness of magnetic resonance (MR) imaging for estimating pulmonary blood volume (PBV) and the variation in PBV throughout the cardiac cycle in experimental heart failure.

MATERIALS AND METHODS

The animal care committee approved this prospective study. Seven pigs were studied before and after myocardial infarction. PBV measurement was validated in a phantom and calculated as the product of cardiac output determined with velocity-encoded MR imaging and the pulmonary transit time for an intravenous bolus of contrast material to pass through the pulmonary circulation. The difference in arterial and venous pulmonary flow during the cardiac cycle was integrated for calculation of the PBV variation (expressed as percentage of stroke volume). Differences were evaluated with the Wilcoxon test.

RESULTS

Calculated and direct phantom measurements of PBV differed by a mean of 4% +/- 3 (standard deviation) (R(2) = 0.97, P < .001). Infarction induced a decrease in left ventricular stroke volume (44 mL +/- 6 vs 27 mL +/- 7; P = .02), ejection fraction (55% +/- 5 vs 41% +/- 4; P = .02), and PBV variation (61% +/- 12 vs 43% +/- 15; P = .04) but not PBV (225 mL +/- 23 vs 211 mL +/- 42; P = .50). The mean pulmonary artery pressure increased after infarction (19 mm Hg +/- 6 vs 27 mm Hg +/- 4; P = .04).

CONCLUSION

Following infarction, the PBV variation but not PBV decreased. PBV variation was the noninvasive measure exhibiting the greatest percentage of change following infarction. MR imaging can be used to assess the variation of the PBV during the cardiac cycle as a marker of heart failure.

摘要

目的

前瞻性评估磁共振成像(MR)在估计实验性心力衰竭患者的肺血容量(PBV)和整个心动周期内 PBV 变化中的作用。

材料与方法

动物护理委员会批准了这项前瞻性研究。7 头猪在心肌梗死后进行了研究。在体模中验证了 PBV 测量值,并将其计算为速度编码 MR 成像确定的心输出量与静脉内团注对比剂通过肺循环的肺通过时间的乘积。通过计算心动周期中肺动脉和肺静脉血流的差异来计算 PBV 变化(表示为每搏量的百分比)。采用 Wilcoxon 检验评估差异。

结果

计算的 PBV 值与体模直接测量值相差 4% +/- 3(标准差)(R2 = 0.97,P <.001)。梗死导致左心室每搏量(44 毫升 +/- 6 比 27 毫升 +/- 7;P =.02)、射血分数(55% +/- 5 比 41% +/- 4;P =.02)和 PBV 变化(61% +/- 12 比 43% +/- 15;P =.04)降低,但 PBV 不变(225 毫升 +/- 23 比 211 毫升 +/- 42;P =.50)。梗死后平均肺动脉压升高(19 毫米汞柱 +/- 6 比 27 毫米汞柱 +/- 4;P =.04)。

结论

梗死后,PBV 变化而非 PBV 减少。PBV 变化是继梗死之后变化百分比最大的非侵入性测量值。MR 成像可用于评估心动周期内 PBV 的变化,作为心力衰竭的标志物。

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