Combination of Real Time Three‐Dimensional Echocardiography with Diagnostic Catheterization to Derive Left Ventricular Pressure‐Volume Relations

Kutty, Shelby; Li, Ling; Padiyath, Asif; Gribben, B S Paul; Gao, Shunji; Lof, John; Bidasee, Keshore R.; Danford, David A.; Küehne, Titus

doi:10.1111/echo.12326

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…For technical reasons, PVL 3D and PVL Cond could not be obtained simultaneously. In contrast to findings in adult pigs [ 22 ], we observed intracavital echocardiographic artifacts in the small ventricles of piglets produced by the conductance catheter which impaired the semiautomatic contour analysis of left ventricular borders during 3DE volume calculation. Therefore the conductance catheter had to be removed during 3DE image acquisition.…”

Section: Discussioncontrasting

confidence: 99%

“…The echocardiographic evaluation of beat-to-beat variability is only possible using the technique of single-beat acquisition of 3D datasets with low temporal and spatial resolution [ 31 ]. Kutty et al [ 22 ] integrated 3D single-beat volume data derived by transesophageal 3DE (TEE) with left ventricular pressure curves from a conductance catheter in adult pig hearts. Despite using TEE, their temporal resolution was poor compared to our study (12–14 3D volumes/s vs. 36.5 ± 2.7 3D volumes/s).…”

Section: Discussionmentioning

confidence: 99%

“…Determination of parallel conductance was done using Baan's equation for parallel conduction [ 13 , 14 ]. For volume calibration SV measured by 3DE using an average of three consecutive baseline measurements was used as reference [ 22 , 23 ].…”

Section: Methodsmentioning

confidence: 99%

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3D Real-Time Echocardiography Combined with Mini Pressure Wire Generate Reliable Pressure-Volume Loops in Small Hearts

et al. 2016

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BackgroundPressure-volume loops (PVL) provide vital information regarding ventricular performance and pathophysiology in cardiac disease. Unfortunately, acquisition of PVL by conductance technology is not feasible in neonates and small children due to the available human catheter size and resulting invasiveness. The aim of the study was to validate the accuracy of PVL in small hearts using volume data obtained by real-time three-dimensional echocardiography (3DE) and simultaneously acquired pressure data.MethodsIn 17 piglets (weight range: 3.6–8.0 kg) left ventricular PVL were generated by 3DE and simultaneous recordings of ventricular pressure using a mini pressure wire (PVL3D). PVL3D were compared to conductance catheter measurements (PVLCond) under various hemodynamic conditions (baseline, alpha-adrenergic stimulation with phenylephrine, beta-adrenoreceptor-blockage using esmolol). In order to validate the accuracy of 3D volumetric data, cardiac magnetic resonance imaging (CMR) was performed in another 8 piglets.ResultsCorrelation between CMR- and 3DE-derived volumes was good (enddiastolic volume: mean bias -0.03ml ±1.34ml). Computation of PVL3D in small hearts was feasible and comparable to results obtained by conductance technology. Bland-Altman analysis showed a low bias between PVL3D and PVLCond. Systolic and diastolic parameters were closely associated (Intraclass-Correlation Coefficient for: systolic myocardial elastance 0.95, arterial elastance 0.93, diastolic relaxation constant tau 0.90, indexed end-diastolic volume 0.98). Hemodynamic changes under different conditions were well detected by both methods (ICC 0.82 to 0.98). Inter- and intra-observer coefficients of variation were below 5% for all parameters.ConclusionsPVL3D generated from 3DE combined with mini pressure wire represent a novel, feasible and reliable method to assess different hemodynamic conditions of cardiac function in hearts comparable to neonate and infant size. This methodology may be integrated into clinical practice and cardiac catheterization programs and has the capability to contribute to clinical decision making even in small hearts.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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3D Real-Time Echocardiography Combined with Mini Pressure Wire Generate Reliable Pressure-Volume Loops in Small Hearts

et al. 2016

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“…Signals were displayed by the CFL-M Inca (CD Leycom, Hengelo, The Netherlands). Volume calibration was done in baseline measurements using end diastolic volume (EDV) and end systolic volume (ESV) obtained by 3DE as references [7,13].…”

Section: Plos Onementioning

confidence: 99%

Assessment of pressure-volume relations in univentricular hearts: Comparison of obtainment by real-time 3D echocardiography and mini pressure-wire with conductance technology

et al. 2021

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Objectives The gold standard to obtain pressure-volume relations (PVR) of the heart, the conductance technology (PVRCond), is rarely used in children. PVR can also be obtained by 3D-echocardiography volume data combined with simultaneously measured pressure data by a mini pressure-wire (PVR3DE). We sought to investigate the feasibility of both methods in patients with univentricular hearts and to compare them, including hemodynamic changes. Methods We studied 19 patients (age 2–29 years). PVR3DE and PVRCond were assessed under baseline conditions and stimulation with dobutamine. Results Obtaining PVR3DE was successful in all patients. Obtaining PVRCond was possible in 15 patients during baseline (79%) and in 12 patients under dobutamine (63%). Both methods showed that end-systolic elastance (Ees) and arterial elastance (Ea) increased under dobutamine and that Tau showed a statistically significant decrease. Intraclass correlation (95% confidence interval) showed moderate to good agreement between methods: Ees: 0.873 (0.711–0.945), Ea: 0.709 (0.336–0.873), Tau: 0.867 (0.697–0.942). Bland-Altman analyses showed an acceptable bias with wider limits of agreement: Ees: 1.63 mmHg/ml (-3.83–7.08 mmHg/ml), Ea: 0.53 mmHg/ml (-5.23–6.28 mmHg/ml), Tau: -0,76 ms (-10.73–9.21 ms). Conclusion Changes of PVR-specific parameters under dobutamine stimulation were reflected in the same way by both methods. However, the absolute values for these parameters could vary between methods and, therefore, methods are not interchangeable. Obtaining PVR3DE in a single ventricle was easier, faster and more successful than PVRCond. PVR3DE provides a promising and needed alternative to the conductance technology for the assessment of cardiac function in univentricular hearts.

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Influence of right ventricular pressure and volume overload on right and left ventricular diastolic function

Jani

Konecny

Shelby

et al. 2022

The Journal of Thoracic and Cardiovascular Surgery

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Combination of Real Time Three‐Dimensional Echocardiography with Diagnostic Catheterization to Derive Left Ventricular Pressure‐Volume Relations

Abstract: Emax can be determined from RT3DE integrated with catheterization-derived pressures. RT3DE is a promising method for enhancing clinical applicability of pressure-volume relations for assessment of myocardial contractility.

Cited by 4 publications

References 26 publications

3D Real-Time Echocardiography Combined with Mini Pressure Wire Generate Reliable Pressure-Volume Loops in Small Hearts

3D Real-Time Echocardiography Combined with Mini Pressure Wire Generate Reliable Pressure-Volume Loops in Small Hearts

Assessment of pressure-volume relations in univentricular hearts: Comparison of obtainment by real-time 3D echocardiography and mini pressure-wire with conductance technology

Influence of right ventricular pressure and volume overload on right and left ventricular diastolic function

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