Jiang L, Weissman N J, Guerrero J L, He J, Weyman A E, Levine R A, Picard M H
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
Heart. 1996 Nov;76(5):442-8. doi: 10.1136/hrt.76.5.442.
To evaluate the feasibility and ability of percutaneous transvenous intracardiac echocardiography (ICE) to image the left ventricle (LV) and monitor its function from the right ventricular (RV) cavity.
A 10 MHz catheter was advanced into the RV from the jugular vein and positioned along the septum at the LV papillary muscle level in five dogs. The catheter was manipulated until a stable catheter position along the septum, which provided on-axis images of LV, was obtained. Different states of LV size and systolic function (n = 80) were created with dobutamine or esmolol, both in the presence and absence of coronary stenoses. LV stroke area (cm2) obtained by ICE was measured at the mid-ventricular level and compared with stroke volume (cm3) obtained simultaneously with a transaortic flow probe. LV end diastolic, end systolic, and stroke areas obtained by ICE were also compared with those obtained by short-axis epicardial echocardiography.
In 96% of the stages, short axis images of the LV could be obtained and measured by ICE. LV end diastolic, end systolic, and stroke areas measured by ICE were not significantly different from epicardial echocardiographic values. Stroke area correlated with stroke volume in each dog (mean correlation coefficient 0.79 (SEE 0.19) cm2) (P < 0.001).
Percutaneous intracardiac ultrasound imaging allows monitoring of LV function from the RV with an accuracy comparable to a short-axis epicardial echocardiogram. The present device can be used in closed chest experimental studies. With the development of lower frequency devices, this technique may be valuable for continuous monitoring of LV function in patients in the intensive care unit or operating room.
评估经皮经静脉心腔内超声心动图（ICE）从右心室（RV）腔对左心室（LV）成像并监测其功能的可行性和能力。
将一根10MHz的导管经颈静脉插入右心室，并在五只犬的左心室乳头肌水平沿室间隔定位。操作导管直至获得沿室间隔的稳定导管位置，该位置可提供左心室的轴位图像。在有和没有冠状动脉狭窄的情况下，使用多巴酚丁胺或艾司洛尔创建左心室大小和收缩功能的不同状态（n = 80）。通过ICE在心室中部水平测量左心室的每搏输出面积（cm²），并与经主动脉流量探头同时获得的每搏输出量（cm³）进行比较。通过ICE获得的左心室舒张末期、收缩末期和每搏输出面积也与短轴心外膜超声心动图获得的结果进行比较。
在96%的阶段中，ICE能够获得并测量左心室的短轴图像。ICE测量的左心室舒张末期、收缩末期和每搏输出面积与心外膜超声心动图的值无显著差异。每只犬的每搏输出面积与每搏输出量相关（平均相关系数0.79（标准误0.19）cm²）（P < 0.001）。
经皮心腔内超声成像能够从右心室监测左心室功能，其准确性与短轴心外膜超声心动图相当。目前的设备可用于闭式胸腔实验研究。随着低频设备的发展，该技术可能对重症监护病房或手术室患者左心室功能的连续监测具有重要价值。
