Use of intravascular ultrasound to measure local compliance of the pediatric pulmonary artery: In vitro studies
Use of intravascular ultrasound to measure local compliance of the pediatric pulmonary artery: In vitro studies
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DOI：
10.1067/mje.2002.126821
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发表时间：
2002-12-01
影响因子：
6.5
通讯作者：
Shandas, R
中科院分区：
文献类型：
--
作者：
Weinberg, CE;Hertzberg, JR;Shandas, R
背景准确测量小儿肺动脉高压的局部肺动脉顺应性是进一步了解该疾病的生物力学和血流动力学方面的重要一步。血管内超声（IVUS）成像技术的出现保证了在临床上进行此类测量的能力。然而，使用IVUS进行依从性测量尚未得到验证。此外，关于衡量合规的最合适方法存在混淆。本研究验证了IVUS测量对激光微米标准的4弹性管的不同顺应性。探讨了两种量化局部顺应性的方法：压力-应变模量（E-P），(E-P (g/cm(2)) = DeltaP x R-d/DeltaR（其中DeltaP为脉压，R-d为舒张半径，DeltaR为收缩期减舒张期半径）和动态顺应性（Cdyn），(C-dyn (%/ 100mmhg) = [DeltaD/(DeltaP x D-d)] × 10(4)，其中DeltaD为收缩期减舒张期直径，D-d为舒张期直径。IVUS直径测量值与激光千分尺数据吻合良好，但存在轻微高估（平均值= 3.67% +/- 2.78%）。e的平均值为353.3 g/cm(2) ~ 2676.0 g/cm(2)；所有管型的平均C-dyn值从5.7%直径变化/100毫米汞柱到39.5%直径变化/100毫米汞柱不等。虽然E-p和C-dyn的平均值可以在不同的管中区分，但E-p的测量不确定度极大，无法进行统计区分。E-p的不确定性随着直径的变化而增加，表明与动脉硬化相关的E-p的潜在限制。结论：我们认为C-dyn。是量化儿童肺动脉顺应性的一个更可靠的方法，特别是当动脉因慢性肺动脉高压而硬化时。
Background The accurate measurement of local pulmonary artery compliance in pediatric pulmonary hypertension is an important step toward further understanding the biomechanical and hemodynamic aspects of the disease. The emergence of intravascular ultrasound (IVUS) imaging techniques promises the ability to make such measurements clinically. However, the use of IVUS for compliance measurements has not been validated. Furthermore, confusion exists regarding the most appropriate method to measure compliance.Metbods. This study validated IVUS measurements against a laser micrometer standard for 4 elastic tubes of varying compliance. Two methods of quantifying local compliance were explored: The pressure-strain modulus (E-P),(E-p(g/cm(2)) = DeltaP x R-d/DeltaR(Where DeltaP is pulse pressure, R-d is diastolic radius, and DeltaR is systolic minus diastolic radii) and the dynamic compliance (Cdyn),(C-dyn (%/100 mm Hg) = [DeltaD/(DeltaP x D-d)] x 10(4)Where DeltaD is systolic minus diastolic diameters and D-d is diastolic diameter.Results. IVUS diameter measurements agreed well with laser micrometer data although slight overestimation (mean = 3.67% +/- 2.78%) was present. Mean values of E. ranged from 353.3 g/cm(2) to 2676.0 g/cm(2); mean C-dyn values ranged from 5.7% diametric change/100 mm Hg to 39.5% diametric change/ 100 mm Hg for all tube models. Although mean values of E-p and C-dyn could be distinguished among the various tubes, the extremely large measurement uncertainty for E-p precluded statistical differentiation. The uncertainty in E-p increased inversely with the diametric change, indicating a potential limitation of E-p associated with stiffening arteries.Conclusions: We conclude that C-dyn. is a more robust mean of quantifying pediatric pulmonary artery compliance, especially as arteries stiffen with chronic pulmonary hypertension.