Real-time three-dimensional echocardiography to construct clinically ready, load-independent indices of myocardial contractile performance - 28/08/11

Doi : 10.1016/S0894-7317(03)00515-7

B.Zane Atkins, MD ^d,^⁎ , Johnny Kuo, BA ^b,^c, Ashish S Shah, MD ^a, Kelley A Hutcheson, BS ^a, Donald D Glower, MD, FACC ^a,^b, Olaf T von Ramm, PhD ^b,^c
^a Departments of Surgery (A.S.S., K.A.H., D.D.G.), Duke University Medical Center, Durham, North CarolinaUSA
^b Department ofBiomedical Engineering (J.K., D.D.G., O.T.V-R.), Duke University Medical Center, Durham, North CarolinaUSA
^c The Center for Emergent Cardiovascular Technologies (J.K., O.T.V-R.), Duke University Medical Center, Durham, North Carolina, USA
^d Department of Surgery, Wilford Hall Medical Center Lackland Air Force Base, Texas, USA (B.Z.A.)

^*Reprint requests: B. Zane Atkins, MD, 59th MDW/MCSG, 2200 Bergquist Dr, Suite 1, San Antonio, TX 78236-5300, USA

Abstract

Background

Real-time 3-dimensional echocardiography (RT3DE) reliably determines intracardiac chamber volumes without left ventricular (LV) geometric assumptions, yet clinical assessment of contractile performance is often on the basis of potentially inaccurate, load-dependent indices such as ejection fraction.

Methods

In 6 chronically instrumented dogs, RT3DE estimated LV volumes at various loading conditions. Preload recruitable stroke work and end-systolic pressure-volume relationships were constructed. RT3DE-derived indices were compared with similar relationships determined by sonomicrometry.

Results

Highly linear preload recruitable stroke work and end-systolic pressure-volume relationships were constructed by RT3DE and sonomicrometry. Mean preload recruitable stroke work slopes correlated between methods, but volume intercepts differed as a result of geometric assumptions of sonomicrometry. Conversely, RT3DE-derived end-systolic pressure-volume relationships did not correlate well with sonomicrometry.

Conclusions

These data are unique in reporting load-independent measures of LV performance using RT3DE. These techniques would strengthen evaluation of LV function after myocardial ischemia or cardiac operation, in which frequent changes in ventricular geometry or loading conditions confound functional assessment by more traditional methods.

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Plan

Methods

Animal instrumentation

Data acquisition

Echocardiographic techniques

Monitoring myocardial contractile performance

Study limitations

Implications

Dr von Ramm is a shareholder of Volumetrics Medical Imaging, Inc.

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Vol 16 - N° 9

P. 922-930 - septembre 2003 Retour au numéro

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Real-time three-dimensional echocardiography to construct clinically ready, load-independent indices of myocardial contractile performance - 28/08/11

Abstract

Background

Methods

Results

Conclusions

Plan

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