Limitations and pitfalls in measurements of right ventricular stroke volume in an animal model of right heart failure

Abstract

Right heart failure occurs in various heart and pulmonary vascular diseases and may be fatal. We aimed to identify limitations in non-invasive measurements of right ventricular stroke volume in an animal model of right ventricular failure. Data from previous studies randomising rats to pulmonary trunk banding (PTB, n = 33) causing pressure-overload right ventricular failure or sham operation (n = 16) was evaluated retrospectively. We measured right ventricular stroke volume by high frequency echocardiography and magnetic resonance imaging (MRI). We found correlation between right ventricular stroke volume measured by echocardiography and MRI in the sham animals (r = 0.677, p = 0.004) but not in the PTB group. Echocardiography overestimated the stroke volume compared to MRI in both groups. Intra- and inter-observer variation did not explain the difference. Technical, physiological and anatomical issues in the pulmonary artery might explain why echocardiography over-estimates stroke volume. Flow acceleration close to the pulmonary artery banding can cause uncertainties in the PTB model and might explain the lack of correlation. In conclusion, we found a correlation in right ventricular stroke volume measured by echocardiography versus MRI in the sham group but not the PTB group. Echocardiography overestimated right ventricular stroke volume compared to MRI.

A 4D flow cardiovascular magnetic resonance study of flow asymmetry and haemodynamic quantity correlations in the pulmonary artery

“…RV dysfunction is also a key feature in various types of congenital heart disease such as tetralogy of Fallot, transposition of the great arteries repaired with atrial switch, Ebstein anomaly and Eisenmenger syndrome (Diller et al 2007). This led to increased importance being placed on the right heart function and RV-pulmonary circulation, since the function of the RV is directly reflected in the pulmonary flow given their mechanical coupling (Vildbrad et al 2015, Braun et al 2018, Hur and Sugeng 2019. Distorted haemodynamic flow pattern is also associated with the surgical repair of congenital heart disease, due to the deviation of the PA from its normal morphology such as in the repair of the transposition of great arteries when the Lecompte manouevre is performed (Capuano et al 2019).…”