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采用心电图门控64层多排螺旋计算机断层扫描、超声心动图和热稀释法对健康犬的心输出量进行测量。

Cardiac output measured by use of electrocardiogram-gated 64-slice multidector computed tomography, echocardiography, and thermodilution in healthy dogs.

作者信息

LeBlanc Nicole L, Scollan Katherine F, Stieger-Vanegas Susanne M

出版信息

Am J Vet Res. 2017 Jul;78(7):818-827. doi: 10.2460/ajvr.78.7.818.

DOI:10.2460/ajvr.78.7.818
PMID:28650244
Abstract

OBJECTIVE To evaluate the accuracy of cardiac output (CO) estimated by use of ECG-gated multidetector CT (MDCT) and 1-, 2-, and 3-D echocardiography and by use of thermodilution. ANIMALS 6 healthy hound-cross dogs. PROCEDURES Electrocardiogram-gated contrast-enhanced 64-slice MDCT and 1-, 2-, and 3-D echocardiography were performed on each dog. The CO for ECG-gated MDCT was calculated as volumetric measurements of stroke volume multiplied by mean heart rate. Echocardiographic left ventricle end-diastolic volumes and end-systolic volumes were measured by use of the Teichholz method (1-D echocardiography) and a single-plane method of disks (2-D echocardiography). Real-time 3-D echocardiographic left ventricle volumes were measured with 3-D functional analysis software on right long-axis and left apical views. The CO of each dog was measured in triplicate by use of thermodilution. Mean CO values, correlations, and limits of agreement for MDCT, echocardiographic modalities, and thermodilution were compared. RESULTS CO measured by use of MDCT, 2-D echocardiography, and 3-D echocardiography had the strongest correlations with CO measured by use of thermodilution. No significant difference in CO was detected between MDCT, any echocardiographic method, and thermodilution. Bland-Altman analysis revealed a systematic underestimation of CO derived by use of MDCT, 2-D echocardiography, and 3-D echocardiography. CONCLUSIONS AND CLINICAL RELEVANCE Use of MDCT, 2-D echocardiography, and 3-D echocardiography to measure CO in healthy dogs was feasible. Measures of CO determined by use of 3-D echocardiography on the right long-axis view were strongly correlated with CO determined by use of thermodilution, with little variance and slight underestimation.

摘要

目的 评估使用心电图门控多层螺旋CT(MDCT)、1D、2D和3D超声心动图以及热稀释法估算心输出量(CO)的准确性。动物 6只健康的杂种猎犬。方法 对每只犬进行心电图门控对比增强64层MDCT和1D、2D及3D超声心动图检查。心电图门控MDCT的CO通过每搏量的容积测量值乘以平均心率来计算。使用Teichholz法(1D超声心动图)和单平面圆盘法(2D超声心动图)测量超声心动图左心室舒张末期容积和收缩末期容积。使用3D功能分析软件在右长轴和左心尖视图上测量实时3D超声心动图左心室容积。通过热稀释法对每只犬的CO进行三次测量。比较MDCT、超声心动图检查方式和热稀释法的平均CO值、相关性和一致性界限。结果 使用MDCT、2D超声心动图和3D超声心动图测量的CO与使用热稀释法测量的CO相关性最强。MDCT、任何超声心动图方法和热稀释法之间在CO方面未检测到显著差异。Bland-Altman分析显示,使用MDCT、2D超声心动图和3D超声心动图得出的CO存在系统性低估。结论及临床意义 在健康犬中使用MDCT、2D超声心动图和3D超声心动图测量CO是可行的。在右长轴视图上使用3D超声心动图测定的CO与使用热稀释法测定的CO高度相关,差异小且有轻微低估。

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