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研究手动通气控制呼吸对健康麻醉犬右心室压力-容积环和超声心动图变量的影响。

Investigation of the influence of manual ventilation-controlled respiration on right ventricular pressure-volume loops and echocardiographic variables in healthy anesthetized dogs.

机构信息

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

出版信息

Am J Vet Res. 2021 Nov;82(11):865-871. doi: 10.2460/ajvr.82.11.865.

DOI:10.2460/ajvr.82.11.865
PMID:34669489
Abstract

OBJECTIVE

To evaluate the influence of manual ventilation-controlled respiration on right ventricular (RV) pressure-volume loop-derived and echocardiographic variables in dogs.

ANIMALS

8 healthy, anesthetized Beagles.

PROCEDURES

In a prospective experimental study, pressure-volume catheters were percutaneously inserted into the right ventricle of each dog, and manual ventilation was performed; RV pressure-volume loop (hemodynamic) data and conventional echocardiographic variables were assessed. Two-dimensional speckle tracking echocardiography-derived RV strain (RVS) and RV systolic strain rate (RVSR) were obtained with RV free wall-only analysis (free wall) and RV global analysis (RVGA; interventricular septum). Variables were compared between end-inspiratory and end-expiratory phases of respiration by statistical methods. Multiple regression analysis was used to assess associations between selected hemodynamic and echocardiographic variables.

RESULTS

The RV pressure significantly increased, and RV volume, stroke volume, tricuspid annular plane systolic excursion, RV fractional area change, peak myocardial systolic velocity of the lateral tricuspid annulus, and RV free wall only-assessed RVS and RVSR significantly decreased in the inspiratory phase, compared with the expiratory phase. There were no significant differences in end-systolic elastance or RVGA-assessed RVS or RVSR between respiratory phases. The RVGA-assessed RVSR was significantly associated with stroke volume and end-systolic elastance.

CONCLUSIONS AND CLINICAL RELEVANCE

Specific RV echocardiographic variables were significantly affected by respiration. In contrast, RVS and RVSR determined with RVGA were not affected by respiration and were associated with hemodynamic indicators of RV contractility.

摘要

目的

评估手动通气控制呼吸对犬右心室(RV)压力-容积环衍生和超声心动图变量的影响。

动物

8 只健康麻醉比格犬。

操作

在一项前瞻性实验研究中,将压力-容积导管经皮插入每只犬的右心室,并进行手动通气;评估 RV 压力-容积环(血流动力学)数据和常规超声心动图变量。通过 RV 游离壁(RV 游离壁)和 RV 整体(RVGA;室间隔)分析获得二维斑点追踪超声心动图衍生的 RV 应变(RVS)和 RV 收缩期应变率(RVSR)。通过统计方法比较呼吸时相的吸气末和呼气末之间的变量。使用多元回归分析评估选定的血流动力学和超声心动图变量之间的关联。

结果

与呼气相比,吸气相 RV 压力显著升高,RV 容积、每搏量、三尖瓣环平面收缩期位移、RV 分数面积变化、外侧三尖瓣环心肌收缩期峰值速度以及 RV 游离壁评估的 RVS 和 RVSR 均显著降低。吸气相与呼气相比,收缩末期弹性或 RVGA 评估的 RVS 或 RVSR 无显著差异。RVGA 评估的 RVSR 与每搏量和收缩末期弹性显著相关。

结论和临床相关性

特定的 RV 超声心动图变量受呼吸显著影响。相比之下,RVGA 确定的 RVS 和 RVSR 不受呼吸影响,与 RV 收缩性的血流动力学指标相关。

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