The relationship between pulmonary artery wedge pressure and pulmonary blood volume derived from contrast echocardiography: A proof‐of‐concept study

Monahan, Ken; Lenihan, Daniel J.; Brittain, Evan L.; Saliba, Linda; Piana, Robert N.; Robison, Leslie L.; Hudson, Melissa M.; Armstrong, Gregory T.

doi:10.1111/echo.14023

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…For each administration of contrast, several sets of ROIs were generated. As in our prior work, 5 mm square ROIs were placed in the RV and LA (“small ROIs”). The RV ROI was placed approximately 1 cm distal to the tricuspid valve leaflet tips equidistant from the interventricular septum and RV free wall.…”

Section: Methodsmentioning

confidence: 99%

Pulmonary transit time from contrast echocardiography and cardiac magnetic resonance imaging: Comparison between modalities and the impact of region of interest characteristics

et al. 2018

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Introduction:The degree of correlation of pulmonary transit time (PTT) between contrast echocardiography and cardiac magnetic resonance imaging (MRI) across the spectrum of cardiac disease has not been quantified. In addition, the degree to which PTT estimates are affected by variation in location and size of regions of interest (ROI) is unknown.Methods: Pulmonary transit time was obtained using an inflection point technique from individuals that underwent contrast echocardiography and cardiac MRI. Right ventricular, left atrial, and left ventricular ROIs were evaluated, and two sizes for each ROI were used. The Spearman correlation coefficient and Bland-Altman analysis were used for comparisons between modalities. Bland-Altman plots were also used to measure the impact of ROI size and location on transit times. Results:Fourteen participants (age: 27-64 years; LV ejection fraction: 30%-60%) underwent both studies a median of 1 week apart. The correlation between modalities was significant for PTT (r = 0.65; P = 0.01) and normalized PTT (r = 0.80; P = 0.001). Cardiac MRI yielded transit times consistently higher than contrast echocardiography (bias ~ 1.4 seconds), but the discordance was not dependent on transit time magnitude. Low bias was observed for comparisons of ROI size and location (<0.5 seconds). Conclusions: Contrast echocardiography underestimates transit time measurementsobtained by cardiac MRI, although the discrepancy was systematic and may have been contributed to by the interval between imaging studies. ROI location and size did not impact transit time values, suggesting that ROIs could be placed without intensive training, a step toward incorporation of real-time PTT measurement into echocardiographic laboratory workflow. K E Y W O R D Scardiac MRI, contrast echocardiography, pulmonary transit time

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Section: Methodsmentioning

confidence: 99%

Pulmonary transit time from contrast echocardiography and cardiac magnetic resonance imaging: Comparison between modalities and the impact of region of interest characteristics

et al. 2018

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Measurement of pulmonary transit time and estimation of pulmonary blood volume after exercise using contrast echocardiography

2022

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Cerebral, Splanchnic, and Renal Transit Time Measurement and Blood Volume Estimation Using Contrast-Enhanced Ultrasonography

Monahan,

Kerrigan,

Shibao

et al. 2024

Ultrasound Quarterly

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We aimed to measure cerebral, splanchnic, and renal transit times and the associated blood volumes using contrast ultrasound. In healthy individuals, regional transit times were calculated from time-intensity curves generated as ultrasound contrast passed through the associated inflow and outflow vessels. These included the internal carotid artery and internal jugular vein (brain), the superior mesenteric artery and portal vein (intestines), and the renal artery and renal vein (kidney). An organ's blood volume relative to the stroke volume delivered to that organ with each cardiac cycle was calculated from the product of heart rate and transit time of contrast passage through the associated vascular bed. The fraction of systemic stroke volume received by each organ was calculated from the respective velocity-time integral and inflow vessel cross-sectional area and used to estimate absolute organ blood volume. The cohort consisted of 16 participants (age: 42 ± 13 years; 5 female) without known cerebrovascular, gastrointestinal, or renal disease. Cerebral, splanchnic, and renal transit times were obtained for 15, 14, and 8 individuals, respectively. Anatomic variability of the renal vessels confounded the acquisition of renal transit times. For all organs, transit times were reproducible and the associated blood volumes were generally comparable to reference values. Cerebral, gastrointestinal, and renal transit times/blood volumes can be reasonably acquired from contrast ultrasound, although the latter is less reliably available. Assessment of the impact on regional blood volumes of pharmacologic or other interventions is a next step toward clinical application of this technique.

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The relationship between pulmonary artery wedge pressure and pulmonary blood volume derived from contrast echocardiography: A proof‐of‐concept study

Abstract: Relative PBV derived from contrast echocardiography correlates with PAWP. If validated in larger studies, rPBV could potentially be used as an alternative to invasively determine left-sided filling pressure.

Cited by 3 publications

References 13 publications

Pulmonary transit time from contrast echocardiography and cardiac magnetic resonance imaging: Comparison between modalities and the impact of region of interest characteristics

Pulmonary transit time from contrast echocardiography and cardiac magnetic resonance imaging: Comparison between modalities and the impact of region of interest characteristics

Measurement of pulmonary transit time and estimation of pulmonary blood volume after exercise using contrast echocardiography

Cerebral, Splanchnic, and Renal Transit Time Measurement and Blood Volume Estimation Using Contrast-Enhanced Ultrasonography

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