Mandour Ahmed S, Farag Ahmed, Helal Mahmoud A Y, El-Masry Gamal, Al-Rejaie Salim, Takahashi Ken, Yoshida Tomohiko, Hamabe Lina, Tanaka Ryou
Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt.
Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo 183-0054, Japan.
Animals (Basel). 2023 Jul 29;13(15):2452. doi: 10.3390/ani13152452.
The assessment of diastolic function has received great interest in order to comprehend its crucial role in the pathophysiology of heart failure and for the early identification of cardiac events. Silent changes in the intraventricular flow (IVF) dynamics occur before the deterioration of the cardiac wall, although they cannot be detected using conventional echocardiography. Collective information on left ventricular (LV) pressures throughout the cardiac cycle has great value when dealing with patients with altered hemodynamics. Accurate pressure measurement inside the ventricle can be obtained by invasive methods to determine the LV diastolic pressures, which reflect the myocardial relaxation and compliance. However, catheterization is only feasible in the laboratory setting and is not suitable for clinical use due to its disadvantages. In contrast, echocardiography is simple, safe, and accessible. Color M-mode echocardiography (CMME) is an advanced cardiac evaluation technique that can measure the intraventricular pressure differences (IVPDs) and intraventricular pressure gradients (IVPGs) based on the Doppler shift of the IVF. Recently, the assessment of IVPD and IVPG has gained growing interest in the cardiovascular literature in both animal and human studies as a non-invasive method for the early diagnosis of cardiac dysfunctions, especially diastolic ones. The usability of IVPD and IVPG has been reported in various surgically induced heart failure or pharmacologically altered cardiac functions in rats, dogs, cats, and goats. This report aims to give an overview of the current studies of CMME-derived IVPD and IVPG in animal studies and its feasibility for clinical application in veterinary practice and to provide the prospects of the technique's ability to improve our understanding.
为了理解舒张功能在心力衰竭病理生理学中的关键作用以及早期识别心脏事件,舒张功能评估受到了广泛关注。尽管使用传统超声心动图无法检测到,但心室内血流(IVF)动力学的无声变化在心脏壁恶化之前就已发生。在处理血流动力学改变的患者时,关于整个心动周期左心室(LV)压力的综合信息具有重要价值。通过侵入性方法可以获得心室内的准确压力测量值,以确定反映心肌舒张和顺应性的LV舒张压。然而,由于其缺点,导管插入术仅在实验室环境中可行,不适合临床使用。相比之下,超声心动图简单、安全且易于操作。彩色M型超声心动图(CMME)是一种先进的心脏评估技术,可根据IVF的多普勒频移测量心室内压力差(IVPDs)和心室内压力梯度(IVPGs)。最近,作为一种早期诊断心脏功能障碍,尤其是舒张功能障碍的非侵入性方法,IVPD和IVPG的评估在动物和人体研究的心血管文献中越来越受到关注。IVPD和IVPG在大鼠、狗、猫和山羊的各种手术诱导的心力衰竭或药物改变的心脏功能中的可用性已有报道。本报告旨在概述动物研究中CMME衍生的IVPD和IVPG的当前研究及其在兽医临床应用中的可行性,并提供该技术增进我们理解能力的前景。