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慢性栓塞性肺动脉高压犬模型中右心超声心动图参数与有创肺动脉压之间的关系

Relationship between right heart echocardiographic parameters and invasive pulmonary artery pressures in canine models of chronic embolic pulmonary hypertension.

作者信息

Akabane Ryota, Shimano Shotaro, Sakatani Atsushi, Ogawa Mizuki, Nagakawa Masayoshi, Miyakawa Hirosumi, Miyagawa Yuichi, Takemura Naoyuki

机构信息

Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan.

出版信息

J Vet Med Sci. 2019 Oct 24;81(10):1485-1491. doi: 10.1292/jvms.19-0350. Epub 2019 Sep 4.

Abstract

Basic information related to the association between right heart echocardiographic parameters and invasive pulmonary artery pressure (PAP) in dogs with pulmonary hypetension (PH) is scarce. The aim of this study was to examine the association between conventional right heart echocardiographic parameters and invasive PAP by right heart catheterization (RHC) before and after PH. Five female beagle dogs regarded as clinically healthy were used. Echocardiography and RHC were conducted before and after creating chronic embolic pulmonary hypertension (CEPH) models. The acceleration time to ejection time ratio in pulmonary artery flow profile (AT/ET), the ratio of the pulmonary artery and aortic diameter in diastole (PA/Ao), the right pulmonary artery distensibility index by M-mode method (RPAD ), the normalized right ventricular internal diameter in diastole (RVIDdn), and the normalized tricuspid annular plane systolic excursion (TAPSEn) were correlated with the invasive systolic PAP (sPAP), mean PAP (mPAP) and diastolic PAP (dPAP). Multiple linear regression analysis identified AT/ET and RVIDdn as independent predictors of sPAP, PA/Ao and RVIDdn as independent predictors of mPAP, and PA/Ao and RPAD as independent predictors of dPAP. AT/ET and PA/Ao had high sensitivity and specificity for predicting CEPH. In conclusion, AT/ET, PA/Ao, RPAD , RVIDdn and TAPSEn were significantly correlated with invasive PAP and alterations in PA/Ao or AT/ET might enable clinicians to predict PH, even if tricuspid regurgitation is not observed.

摘要

关于肺动脉高压(PH)犬右心超声心动图参数与有创肺动脉压(PAP)之间关联的基础信息较少。本研究的目的是检查常规右心超声心动图参数与有创PAP在PH发生前后通过右心导管插入术(RHC)测得的关联。使用了5只临床健康的雌性比格犬。在建立慢性栓塞性肺动脉高压(CEPH)模型前后进行了超声心动图检查和RHC。肺动脉血流频谱中的加速时间与射血时间比值(AT/ET)、舒张期肺动脉与主动脉直径比值(PA/Ao)、M型法测得的右肺动脉扩张性指数(RPAD)、舒张期标准化右心室内径(RVIDdn)以及标准化三尖瓣环平面收缩期位移(TAPSEn)与有创收缩期PAP(sPAP)、平均PAP(mPAP)和舒张期PAP(dPAP)相关。多元线性回归分析确定AT/ET和RVIDdn为sPAP的独立预测因子,PA/Ao和RVIDdn为mPAP的独立预测因子,PA/Ao和RPAD为dPAP的独立预测因子。AT/ET和PA/Ao对预测CEPH具有高敏感性和特异性。总之,AT/ET、PA/Ao、RPAD、RVIDdn和TAPSEn与有创PAP显著相关,并且即使未观察到三尖瓣反流,PA/Ao或AT/ET的改变也可能使临床医生能够预测PH。

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