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二维剪切波弹性成像技术在诱导容量超负荷犬右心房压力无创、可靠评估中的应用。

Effectiveness of 2-dimensional shear wave elastography for noninvasive and reliable estimation of right atrial pressure in dogs with induced volume overload.

机构信息

Laboratory of Companion Animal Internal Medicine, Department of Companion Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido, Japan.

Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

出版信息

J Vet Intern Med. 2023 May-Jun;37(3):866-874. doi: 10.1111/jvim.16705. Epub 2023 Apr 10.

Abstract

BACKGROUND

Two-dimensional shear wave elastography (2D-SWE) provides information on hepatic elastic modulus as shear wave velocity (SWV).

HYPOTHESIS/OBJECTIVES: To assess SWV using 2D-SWE in dogs with induced volume overload, investigate the relationship between this information and right atrial pressure (RAP) measured by invasive right heart catheterization, and also evaluate the difference in SWV before and after diuretic administration.

ANIMALS

Six healthy beagles.

METHODS

Prospective experimental study. Right heart catheterization and 2D-SWE were performed in 6 anesthetized beagles at baseline and after the induction of volume overload. Volume overload was induced by IV hydroxyethyl starch 70/0.5 infusion (100 mL/kg/h). Furosemide (4-6 mg/kg, IV) was administered, and the SWVs were measured.

RESULTS

Shear wave velocity showed a significant gradual increase during acute volume overload compared to baseline. SWV was significantly positively correlated with RAP (P < .0001, ρ = 0.9729). The area under the curve of SWV to predict RAP at >10, >15, and >20 mm Hg was 0.9896 (95% confidence interval [95% CI], 0.9690-1.000), 0.9907 (95% CI, 0.9701-1.000), and 0.9722 (95% CI, 0.9280-1.000), respectively. The SWV after diuretic use decreased significantly.

CONCLUSIONS AND CLINICAL IMPORTANCE

Two-dimensional shear wave elastography might be useful for noninvasive and reliable estimation of RAP in dogs with acute volume overload and has potential as a quantitative biomarker for evaluating therapeutic response in dogs with right sided congestive heart failure.

摘要

背景

二维剪切波弹性成像(2D-SWE)通过剪切波速度(SWV)提供肝弹性模量的信息。

假说/目的:评估诱导容量超负荷犬的 SWV,研究此信息与经皮右心导管测量的右心房压力(RAP)之间的关系,并评估利尿治疗前后 SWV 的差异。

动物

6 只健康比格犬。

方法

前瞻性实验研究。在 6 只麻醉比格犬的基础状态和容量超负荷后进行右心导管检查和 2D-SWE。通过静脉输注羟乙基淀粉 70/0.5(100mL/kg/h)诱导容量超负荷。给予呋塞米(4-6mg/kg,静脉),并测量 SWV。

结果

与基础状态相比,急性容量超负荷期间 SWV 逐渐显著增加。SWV 与 RAP 呈显著正相关(P<0.0001,ρ=0.9729)。SWV 预测 RAP>10mmHg、>15mmHg 和>20mmHg 的曲线下面积分别为 0.9896(95%可信区间[95%CI],0.9690-1.000)、0.9907(95%CI,0.9701-1.000)和 0.9722(95%CI,0.9280-1.000)。利尿后 SWV 显著降低。

结论和临床意义

2D-SWE 可能有助于非侵入性和可靠地估计急性容量超负荷犬的 RAP,并有可能成为评估右侧充血性心力衰竭犬治疗反应的定量生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba5c/10229340/5d9196492b73/JVIM-37-866-g002.jpg

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