Drees Randi, Johnson Rebecca A, Stepien Rebecca L, Munoz Del Rio Alejandro, François Christopher J
VMTH DSS, UW-Madison, Madison, WI, 53726, USA.
Vet Radiol Ultrasound. 2015 Mar-Apr;56(2):168-75. doi: 10.1111/vru.12200. Epub 2014 Aug 15.
Companion animals are routinely anesthetized or heavily sedated for cardiac MRI studies, however effects of varying anesthetic protocols on cardiac function measurements are incompletely understood. The purpose of this prospective study was to compare effects of two anesthetic protocols (Protocol A: Midazolam, fentanyl; Protocol B: Dexmedetomidine) on quantitative and qualitative blood flow values measured through the aortic, pulmonic, mitral, and tricuspid valves using two-dimensional phase contrast magnetic resonance imaging (2D PC MRI) in healthy dogs. Mean flow per heartbeat values through the pulmonary artery (Qp) and aorta (Qs) were compared to right and left ventricular stroke volumes (RVSV, LVSV) measured using a reference standard of 2D Cine balanced steady-state free precession MRI. Pulmonary to systemic flow ratio (Qp/Qs) was also calculated. Differences in flow and Qp/Qs values generated using 2D PC MRI did not differ between the two anesthetic protocols (P = 1). Mean differences between Qp and RVSV were 3.82 ml/beat (95% limits of agreement: 3.62, -11.26) and 1.9 ml/beat (-7.86, 11.66) for anesthesia protocols A and B, respectively. Mean differences between Qs and LVSV were 1.65 ml/beat (-5.04, 8.34) and 0.03 ml/beat (-4.65, 4.72) for anesthesia protocols A and B, respectively. Mild tricuspid or mitral reflux was seen in 2/10 dogs using 2D PC MRI. No aortic or pulmonic insufficiency was observed. Findings from the current study indicated that these two anesthetic protocols yield similar functional measures of cardiac blood flow using 2D PC MRI in healthy dogs. Future studies in clinically affected patients are needed.
伴侣动物在进行心脏磁共振成像(MRI)研究时通常会接受麻醉或深度镇静,然而,不同麻醉方案对心功能测量的影响尚未完全明确。本前瞻性研究的目的是比较两种麻醉方案(方案A:咪达唑仑、芬太尼;方案B:右美托咪定)对健康犬使用二维相位对比磁共振成像(2D PC MRI)通过主动脉瓣、肺动脉瓣、二尖瓣和三尖瓣测量的定量和定性血流值的影响。将通过肺动脉(Qp)和主动脉(Qs)的每搏平均流量值与使用二维电影稳态自由进动MRI参考标准测量的右心室和左心室每搏输出量(RVSV、LVSV)进行比较。还计算了肺循环与体循环血流量比值(Qp/Qs)。两种麻醉方案使用2D PC MRI产生的血流和Qp/Qs值差异无统计学意义(P = 1)。麻醉方案A和B的Qp与RVSV之间的平均差异分别为3.82 ml/搏(95%一致性界限:3.62,-
-11.26)和1.9 ml/搏(-7.86,11.66)。麻醉方案A和B的Qs与LVSV之间的平均差异分别为1.65 ml/搏(-5.04,8.34)和0.03 ml/搏(-4.65,4.72)。使用2D PC MRI在10只犬中有2只出现轻度三尖瓣或二尖瓣反流。未观察到主动脉瓣或肺动脉瓣关闭不全。本研究结果表明,这两种麻醉方案在健康犬中使用2D PC MRI可产生相似的心脏血流功能测量值。未来需要对临床患病动物进行研究。