Utility of Real-Time Three-Dimensional Echocardiography for the Assessment of Right Ventricular Morphology and Function in Large Animal Models.
Utility of Real-Time Three-Dimensional Echocardiography for the Assessment of Right Ventricular Morphology and Function in Large Animal Models.
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DOI：
10.3390/jcm11072001
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发表时间：
2022-04-02
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
--
作者：
实时三维超声心动图（RT 3DE）能够无创评估右心室（RV）形态。然而，没有研究评价RT 3DE和RV压力-容积环获得的RV功能之间的关系。这项假设驱动的实验研究旨在评估RT 3DE在评价RV形态和功能方面的实用性。10只麻醉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RV收缩力和负荷条件。在每个研究方案中进行了RV压力-容积环衍生的血流动力学测量和超声心动图，包括二维斑点追踪超声心动图和RT 3DE。Bland-Altman分析显示右心导管和RT 3DE获得的RV容积、射血分数和每搏输出量高度一致。多元回归分析显示，三尖瓣外侧环（RV s '）的峰值心肌速度和整体RV纵向应变率与收缩末期弹性显著相关（校正r2 = 0.66，p < 0.001）。RV s '、RV游离壁纵向应变和RT 3DE导出的每搏输出量/收缩末期RV容积比与RV压力-容积环导出的收缩末期/动脉弹性比相关（校正r2 = 0.34，p < 0.001）。RT 3DE可以检测插管后右心室容积的变化，具有很好的一致性，并且可能有助于估计右心室-肺动脉耦合。
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.
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