Peper Eva S, Leopaldi Alberto M, van Tuijl Sjoerd, Coolen Bram F, Strijkers Gustav J, Baan Jan, Planken R Nils, de Weger Arend, Nederveen Aart J, Marquering Henk A, van Ooij Pim
Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
LifeTec Group, Eindhoven, The Netherlands.
Eur Radiol Exp. 2019 Oct 25;3(1):40. doi: 10.1186/s41747-019-0114-5.
Cardiac magnetic resonance imaging (MRI) in large animals is cumbersome for various reasons, including ethical considerations, costs of housing and maintenance, and need for anaesthesia. Our primary purpose was to show the feasibility of an isolated beating pig heart model for four-dimensional (4D) flow MRI for investigating intracardiac blood flow patterns and flow parameters using slaughterhouse side products. In addition, the feasibility of evaluating transcatheter aortic valve replacement (TAVR) in the model was investigated.
Seven slaughterhouse pig hearts were installed in the MRI-compatible isolated beating pig heart platform. First, Langendorff perfusion mode was established; then, the system switched to working mode, in which blood was actively pumped by the left ventricle. A pacemaker ensured a stable HR during 3-T MRI scanning. All hearts were submitted to human physiological conditions of cardiac output and stayed vital for several hours. Aortic flow was measured from which stroke volume, cardiac output, and regurgitation fraction were calculated.
4D flow MRI acquisitions were successfully conducted in all hearts. Stroke volume was 31 ± 6 mL (mean ± standard deviation), cardiac output 3.3 ± 0.9 L/min, and regurgitation fraction 16% ± 9%. With 4D flow, intracardiac and coronary flow patterns could be visualised in all hearts. In addition, we could study valve function and regurgitation in two hearts after TAVR.
The feasibility of 4D flow MRI in an isolated beating pig heart loaded to physiological conditions was demonstrated. The platform is promising for preclinical assessment of cardiac blood flow and function.
由于多种原因，包括伦理考量、饲养和维护成本以及麻醉需求，对大型动物进行心脏磁共振成像（MRI）操作繁琐。我们的主要目的是展示使用屠宰场副产品构建的离体搏动猪心脏模型用于四维（4D）血流MRI以研究心内血流模式和血流参数的可行性。此外，还研究了在该模型中评估经导管主动脉瓣置换术（TAVR）的可行性。
将七个屠宰场猪心脏安装在与MRI兼容的离体搏动猪心脏平台上。首先，建立Langendorff灌注模式；然后，系统切换至工作模式，即由左心室主动泵血。起搏器确保在3-T MRI扫描期间心率稳定。所有心脏均处于人体心输出量的生理条件下，并能维持数小时的生命活动。测量主动脉血流，据此计算每搏输出量、心输出量和反流分数。
所有心脏均成功进行了4D血流MRI采集。每搏输出量为31±6 mL（平均值±标准差），心输出量为3.3±0.9 L/min，反流分数为16%±9%。通过4D血流成像，所有心脏的心内和冠状动脉血流模式均可可视化。此外，我们还能在两个心脏进行TAVR术后研究瓣膜功能和反流情况。
证明了在加载至生理条件的离体搏动猪心脏中进行4D血流MRI的可行性。该平台有望用于心脏血流和功能的临床前评估。
