Yuchi Yunosuke, Suzuki Ryohei, Higuchi Riho, Saito Takahiro, Teshima Takahiro, Matsumoto Hirotaka, Koyama Hidekazu
Laboratory of Veterinary Internal Medicine, School of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo 180-8602, Japan.
J Clin Med. 2022 Apr 2;11(7):2001. doi: 10.3390/jcm11072001.
Real-time three-dimensional echocardiography (RT3DE) enables a noninvasive assessment of right ventricular (RV) morphology. However, no study has evaluated the relationship between RV function obtained by RT3DE and RV pressure-volume loops. This hypothesis-driven, experimental study aimed to assess the utility of RT3DE in the evaluation of RV morphology and function. Ten anesthetized beagle dogs sequentially underwent dobutamine infusion, acute infusion of lactated Ringer’s solution, and furosemide administration to alter RV contractility and loading conditions. RV pressure-volume loop-derived hemodynamic measurements and echocardiography, including two-dimensional speckle-tracking echocardiography and RT3DE, were performed in each study protocol. Bland−Altman analysis showed strong agreement in RV volume, ejection fraction, and stroke volume obtained by right heart catheterization and RT3DE. Multiple regression analyses revealed that the peak myocardial velocity of the lateral tricuspid annulus (RV s’) and global RV longitudinal strain rate were significantly associated with end-systolic elastance (adjusted r2 = 0.66, p < 0.001). RV s’, RV free wall longitudinal strain, and RT3DE-derived stroke volume/end-systolic RV volume ratio were associated with RV pressure-volume loops-derived end-systolic/arterial elastance ratio (adjusted r2 = 0.34, p < 0.001). RT3DE could detect the changes in catheterization-derived RV volume with a strong agreement and might be useful in estimating RV-pulmonary arterial coupling.
实时三维超声心动图（RT3DE）能够对右心室（RV）形态进行无创评估。然而，尚无研究评估通过RT3DE获得的右心室功能与右心室压力-容积环之间的关系。这项基于假设的实验性研究旨在评估RT3DE在评估右心室形态和功能方面的效用。十只麻醉后的比格犬依次接受多巴酚丁胺输注、乳酸林格氏液急性输注和呋塞米给药，以改变右心室收缩力和负荷条件。在每个研究方案中均进行了右心室压力-容积环衍生的血流动力学测量以及超声心动图检查，包括二维斑点追踪超声心动图和RT3DE。布兰德-奥特曼分析显示，通过右心导管检查和RT3DE获得的右心室容积、射血分数和每搏输出量具有高度一致性。多元回归分析显示，三尖瓣环外侧（RV s’）的心肌峰值速度和右心室整体纵向应变率与收缩末期弹性显著相关（调整后r2 = 0.66，p < 0.001）。RV s’、右心室游离壁纵向应变以及RT3DE衍生的每搏输出量/收缩末期右心室容积比值与右心室压力-容积环衍生的收缩末期/动脉弹性比值相关（调整后r2 = 0.34，p < 0.001）。RT3DE能够高度一致地检测出导管检查衍生的右心室容积变化，可能有助于评估右心室-肺动脉耦合。
