Validation of high-resolution echocardiography and magnetic resonance imaging vs. high-fidelity catheterization in experimental pulmonary hypertension
Validation of high-resolution echocardiography and magnetic resonance imaging vs. high-fidelity catheterization in experimental pulmonary hypertension
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DOI：
10.1152/ajplung.00114.2010
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发表时间：
2010-09-01
影响因子：
4.9
通讯作者：
Archer, Stephen L.
中科院分区：
文献类型：
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作者：
Urboniene, Dalia;Haber, Idith;Archer, Stephen L.
Urboniene D，Haber I，Fang Y-H，Thenappan T，Archer SL.实验性肺动脉高压中高分辨率超声心动图和磁共振成像与高保真导管检查的验证。美国生理学杂志肺细胞分子生理学299：L401-L412，2010年。首次发表于2010年6月25日; doi：10.1152/ajplung.00114.2010.-高频超声心动图和高场强磁共振成像（MRI）是定量肺动脉高压（PAH）和右心室（RV）肥大（RVH）的新的无创方法。我们在野百合碱诱导的PAH大鼠和正常对照组中，将这些评估肺循环的无创方法与金标准心导管插入术（微压计尖端导管）进行了比较。用吸入异氟烷麻醉闭胸的Sprague-Dawley大鼠（25只野百合碱，6只年龄匹配的对照）。非侵入性研究使用37.5 MHz超声（Vevo 770; VisualSonics）或9.4 T MRI（Bruker Bio-Spin）。导管插入术使用1.4-F微压计头端Millar导管和热稀释导管测量心输出量（CO）。我们比较了无创测量肺动脉（PA）压力（PAP），使用PA加速时间（PAAT）和CO，使用几何PA流量法和RV游离壁（RVFW）厚度/质量与心导管和/或尸检。设盲操作员在2天内使用每种方法进行比较。在患有野百合碱PAH的大鼠亚组中，每周超声心动图、导管插入术和尸检数据评估疾病进展。所有研究期间的心率相似（>323次/分）。在野百合碱治疗3周内，PAAT缩短，PA血流包络显示收缩期“切迹”，反映下游血管重塑/硬化。PAAT的MRI和超声心动图测量值高度相关（r（2）= 0.87），与侵入性平均PAP成反比（r（2）= 0.72）。通过超声心动图估计的平均PAP为58.7 -（1.21 X PAAT）。有创和无创CO测量相关性良好（r（2）>= 0.75）。RVFW厚度/质量的非侵入性测量与死后测量相关性良好。我们的结论是，高分辨率超声心动图和MRI准确地确定CO，PAP和RV厚度/质量，提供了类似的结果，高保真右心导管和尸检，PAAT准确估计PAP，并允许连续监测实验性PAH。这些工具可用于评估啮齿动物肺循环和RVH。
Urboniene D, Haber I, Fang Y-H, Thenappan T, Archer SL. Validation of high-resolution echocardiography and magnetic resonance imaging vs. high-fidelity catheterization in experimental pulmonary hypertension. Am J Physiol Lung Cell Mol Physiol 299: L401-L412, 2010. First published June 25, 2010; doi:10.1152/ajplung.00114.2010.-High-frequency echocardiography and high-field-strength magnetic resonance imaging (MRI) are new noninvasive methods for quantifying pulmonary arterial hypertension (PAH) and right ventricular (RV) hypertrophy (RVH). We compared these noninvasive methods of assessing the pulmonary circulation to the gold standard, cardiac catheterization (micromanometer-tipped catheters), in rats with monocrotaline- induced PAH and normal controls. Closed-chest, Sprague-Dawley rats were anesthetized with inhaled isoflurane (25 monocrotaline, 6 age-matched controls). Noninvasive studies used 37.5-MHz ultrasound (Vevo 770; VisualSonics) or a 9.4-T MRI (Bruker Bio-Spin). Catheterization used a 1.4-F micromanometer-tipped Millar catheter and a thermodilution catheter to measure cardiac output (CO). We compared noninvasive measures of pulmonary artery (PA) pressure (PAP) using PA acceleration time (PAAT) and CO, using the geometric PA flow method and RV free wall (RVFW) thickness/mass with cardiac catheterization and/or autopsy. Blinded operators performed comparisons using each method within 2 days of another. In a subset of rats with monocrotaline PAH, weekly echocardiograms, catheterization, and autopsy data assessed disease progression. Heart rate was similar during all studies (>323 beats/min). PAAT shortened, and the PA flow envelope displayed systolic "notching," reflective of downstream vascular remodeling/stiffening, within 3 wk of monocrotaline. MRI and echocardiography measures of PAAT were highly correlated (r(2) = 0.87) and were inversely proportional to invasive mean PAP (r(2) = 0.72). Mean PAP by echocardiography was estimated as 58.7 - (1.21 X PAAT). Invasive and noninvasive CO measurement correlated well (r(2) >= 0.75). Noninvasive measures of RVFW thickness/mass correlated well with postmortem measurements. We conclude that high-resolution echocardiography and MRI accurately determine CO, PAP, and RV thickness/mass, offering similar results as high-fidelity right heart catheterization and autopsy, and that PAAT accurately estimates PAP and permits serial monitoring of experimental PAH. These tools are useful for assessment of the rodent pulmonary circulation and RVH.