Zheng Haining, Jin Yan, Fu Yuwei, Zhao Rui, Wang Xiaoqing, Wen Chaoyang
Department of Ultrasound, Peking University International Hospital, Beijing, China.
Department of Cardiology, Northern Theater General Hospital of the Chinese People's Liberation Army, Shenyang, China.
Ann Transl Med. 2022 Jan;10(2):105. doi: 10.21037/atm-21-6913.
This study sought to investigate the accuracy of estimating left atrial pressure (LAP) using the continuous wave Doppler spectrum of mitral regurgitation.
Dog models of left atrial hypertension with mitral regurgitation were established with disposable biopsy forceps and the injection of melamine formaldehyde resin microsphere suspension. A total of 40 models of left atrial hypertension with different hemodynamic statuses were established by injecting either esmolol or dobutamine in which the spectrums of mitral regurgitation were clear and the regurgitation velocity exceeded 3.5 m/s. The continuous wave Doppler spectrums of mitral regurgitation were recorded and analyzed to estimate left atrial pressure (LAP). The mean left atrial pressure (LAP), the isovolumic diastolic left atrial pressure (LAP), the maximum left atrial pressure (LAP), and the minimum left atrial pressure (LAP) were also measured using the catheter method in the same cardiac cycle.
The LAP (mean ± standard deviation; 11.77±4.36 mmHg) was correlated with the LAP (11.51±4.77 mmHg; r=0.887, P=0.000), but the difference was not statistically significant (P=0.459). The LAP was correlated with the LAP (12.16±4.72 mmHg; r=0.883, P=0.000), but the difference was not statistically significant (P=0.271). There was a correlation between the LAP and the LAP (r=0.987, P=0.000), and the difference was statistically significant (P=0.000).
This study suggests that the ultrasound evaluation of LAP correlates well with LAP measured using the gold standard catheter method, and is a simple, convenient, non-invasive method to quantitatively estimate LAP. This method is promising, but further large-scale animal experiments and clinical studies need to be conducted.
本研究旨在探讨利用二尖瓣反流的连续波多普勒频谱估算左心房压力（LAP）的准确性。
使用一次性活检钳并注射三聚氰胺甲醛树脂微球混悬液建立伴有二尖瓣反流的左心房高压犬模型。通过注射艾司洛尔或多巴酚丁胺建立了40个不同血流动力学状态的左心房高压模型，其中二尖瓣反流频谱清晰，反流速度超过3.5m/s。记录并分析二尖瓣反流的连续波多普勒频谱以估算左心房压力（LAP）。在同一心动周期中，还采用导管法测量平均左心房压力（LAP）、等容舒张期左心房压力（LAP）、最大左心房压力（LAP）和最小左心房压力（LAP）。
LAP（均值±标准差；11.77±4.36mmHg）与LAP（11.51±4.77mmHg；r=0.887，P=0.000）相关，但差异无统计学意义（P=0.459）。LAP与LAP（12.16±4.72mmHg；r=0.883，P=0.000）相关，但差异无统计学意义（P=0.271）。LAP与LAP之间存在相关性（r=0.987，P=0.000），且差异有统计学意义（P=0.000）。
本研究表明，LAP的超声评估与采用金标准导管法测量的LAP具有良好的相关性，是一种简单、便捷、无创的定量估算LAP的方法。该方法具有前景，但需要进一步开展大规模动物实验和临床研究。
