Pulmonary transit time measurement by contrast-enhanced ultrasound in left ventricular dyssynchrony

Echo Research and Practice - Tập 3 Số 2 - Trang 35-43 - 2016
I Herold1, Salvatore Saporito2, Massimo Mischi2, H.C. van Assen2, R. Arthur Bouwman1, Anouk G.W. de Lepper3, Harrie C. M. van den Bosch4, H.H.M. Korsten2, Patrick Houthuizen2
1Department of Anesthesiology and Intensive-Care, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
2Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, Eindhoven, The Netherlands
3Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
4Department of Radiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands

Tóm tắt

Abstract Background: Pulmonary transit time (PTT) is an indirect measure of preload and left ventricular function, which can be estimated using the indicator dilution theory by contrast-enhanced ultrasound (CEUS). In this study, we first assessed the accuracy of PTT-CEUS by comparing it with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Secondly, we tested the hypothesis that PTT-CEUS correlates with the severity of heart failure, assessed by MRI and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Methods and results: Twenty patients referred to our hospital for cardiac resynchronization therapy (CRT) were enrolled. DCE-MRI, CEUS, and NT-proBNP measurements were performed within an hour. Mean transit time (MTT) was obtained by estimating the time evolution of indicator concentration within regions of interest drawn in the right and left ventricles in video loops of DCE-MRI and CEUS. PTT was estimated as the difference of the left and right ventricular MTT. Normalized PTT (nPTT) was obtained by multiplication of PTT with the heart rate. Mean PTT-CEUS was 10.5±2.4s and PTT-DCE-MRI was 10.4±2.0s (P=0.88). The correlations of PTT and nPTT by CEUS and DCE-MRI were strong; r=0.75 (P=0.0001) and r=0.76 (P=0.0001), respectively. Bland–Altman analysis revealed a bias of 0.1s for PTT. nPTT-CEUS correlated moderately with left ventricle volumes. The correlations for PTT-CEUS and nPTT-CEUS were moderate to strong with NT-proBNP; r=0.54 (P=0.022) and r=0.68 (P=0.002), respectively. Conclusions: (n)PTT-CEUS showed strong agreement with that by DCE-MRI. Given the good correlation with NT-proBNP level, (n)PTT-CEUS may provide a novel, clinically feasible measure to quantify the severity of heart failure. Clinical Trial Registry: NCT01735838

Từ khóa


Tài liệu tham khảo

Sakka SG, Reuter DA & Perel A 2012 The transpulmonary thermodilution technique. Journal of Clinical Monitoring and Computing 26 347–353. (doi:10.1007/s10877-012-9378-5)

Roy SB, Bhardwaj P & Bhatia ML 1965 Pulmonary blood volume in mitral stenosis. BMJ 2 1466–1469.

Shors SM, Cotts WG, Pavlovic-Surjancev B, Francois CJ, Gheorghiade M, Finn JP 2003 Heart failure: evaluation of cardiopulmonary transit times with time-resolved MR angiography. Radiology 229 743–748. (doi:10.1148/radiol.2293021363)

Cao JJ, Wang Y, McLaughlin J, Haag E, Rhee P, Passick M, Toole R, Cheng J, Berke AD & Lachman J, et al. 2011 Left ventricular filling pressure assessment using left atrial transit time by cardiac magnetic resonance imaging. Circulation: Cardiovascular Imaging 4 130–138. (doi:10.1161/CIRCIMAGING.110.959569)

Brittain EL, Doss LN, Saliba L, Irani W, Byrd BF & Monahan K 2015 Feasibility and diagnostic potential of pulmonary transit time measurement by contrast echocardiography: a pilot study. Echocardiography 32 1564–1571. (doi:10.1111/echo.12906)

Mischi M, Kalker TA & Korsten EH 2004 Contrast echocardiography for pulmonary blood volume quantification. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control 51 1137–1147.

Herold IH, Soliman Hamad MA, van Assen HC, Bouwman RA, Korsten HH, & Mischi M 2015 Pulmonary blood volume measured by contrast enhanced ultrasound: a comparison with transpulmonary thermodilution. British Journal of Anaesthesia 115 53–60. (doi:10.1093/bja/aeu554)

Streitberger A, Modler P & Haggstrom J 2015 Increased normalized pulmonary transit times and pulmonary blood volumes in cardiomyopathic cats with or without congestive heart failure. Journal of Veterinary Cardiology 17 25–33. (doi:10.1016/j.jvc.2014.09.005)

Herold IH, Russo G, Mischi M, Houthuizen P, Saidov T, van het Veer M, van Assen HC & Korsten HH 2013 Volume quantification by contrast-enhanced ultrasound: an in-vitro comparison with true volumes and thermodilution. Cardiovasc Ultrasound 11 36. (doi:10.1186/1476-7120-11-36)

Choi BG, Sanai R, Yang B, Young HA, Mazhari R, Reiner JS & Lewis JF 2014 Estimation of cardiac output and pulmonary vascular resistance by contrast echocardiography transit time measurement: a prospective pilot study. Cardiovascular Ultrasound 12 44. (doi:10.1186/1476-7120-12-44)

Mischi M, van den Bosch HC, den Boer JA, Verwoerd J, Grouls RJ, Peels CH, Korsten HH 2009 Intra-thoracic blood volume measurement by contrast magnetic resonance imaging. Magnetic Resonance in Medicine 61 344–353. (doi:10.1002/mrm.21824)

Sheppard CW & Savage LJ 1951 The random walk problem in relation to the physiology of circulatory mixing. Physical Review 83 489–490.

Wise ME 1966 Tracer dilution curves in cardiology and random walk and lognormal distributions. Acta Physiologica et Pharmacologica Neerlandica 14 175–204.

Mischi M, Kalker T & Korsten HHM 2003 Videodensitometric methods for cardiac output measurements. EURASIP Journal on Applied Signal Processing 5 479–489. (doi:10.1155/S1110865703211185)

Lord P, Eriksson A, Haggstrom J, Jarvinen AK, Kvart C, Hansson K, Maripuu E & Makela O 2003 Increased pulmonary transit times in asymptomatic dogs with mitral regurgitation. Journal of Veterinary Internal Medicine 17 824–829. (doi:10.1111/j.1939-1676.2003.tb02521.x)

Bax JJ, Ansalone G, Breithardt OA, Derumeaux G, Leclercq C, Schalij MJ, Sogaard P, St John Sutton M & Nihoyannopoulos P 2004 Echocardiographic evaluation of cardiac resynchronization therapy: ready for routine clinical use? A critical appraisal. Journal of the American College of Cardiology 44 1–9. (doi:10.1016/j.jacc.2004.02.055)

Pitzalis MV, Iacoviello M, Romito R, Massari F, Rizzon B, Luzzi G, Guida P, Andriani A, Mastropasqua F & Rizzon P 2002 Cardiac resynchronization therapy tailored by echocardiographic evaluation of ventricular asynchrony. Journal of the American College of Cardiology 40 1615–1622.

Herold IH, Saporito S, Bouwman RA, Houthuizen P, van Assen HC, Mischi M & Korsten HH 2016 Reliability, repeatability, and reproducibility of pulmonary transit time assessment by contrast enhanced echocardiography. Cardiovascular Ultrasound 14 1. (doi:10.1186/s12947-015-0044-1)

Taub PR, Gabbai-Saldate P & Maisel A 2010 Biomarkers of heart failure. Congestive Heart Failure 16 S19–S24. (doi:10.1111/j.1751-7133.2010.00168.x)

Fruhwald FM, Fahrleitner-Pammer A, Berger R, Leyva F, Freemantle N, Erdmann E, Gras D, Kappenberger L, Tavazzi L, Daubert JC, et al. 2007 Early and sustained effects of cardiac resynchronization therapy on N-terminal pro-B-type natriuretic peptide in patients with moderate to severe heart failure and cardiac dyssynchrony. European Heart Journal 28 1592–1597. (doi:10.1093/eurheartj/ehl505)

Bland JM & Altman DG 1986 Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1 307–310. (doi:10.1016/S0140-6736(86)90837-8)

Evans JD 1996 Straightforward Statistics for the Behavioral Sciences. Pacific Grove, CA, USA: Brooks/Cole Publishing Company.

Malm S, Frigstad S, Sagberg E, Larsson H & Skjaerpe T 2004 Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography: a comparison with magnetic resonance imaging. Journal of the American College of Cardiology 44 1030–1035. (doi:10.1016/j.jacc.2004.05.068)

Sapin PM, Schroeder KM, Gopal AS, Smith MD & King DL 1995 Three-dimensional echocardiography: limitations of apical biplane imaging for measurement of left ventricular volume. Journal of the American Society of Echocardiography 8 576–584. (doi:10.1016/S0894-7317(05)80370-0)

Streitberger A, Hocke V & Modler P 2013 Measurement of pulmonary transit time in healthy cats by use of ultrasound contrast media “Sonovue(R)”: feasibility, reproducibility, and values in 42 cats. Journal of Veterinary Cardiology 15 181–187. (doi:10.1016/j.jvc.2013.05.001)

Falch DK & Stromme SB 1979 Pulmonary blood volume and interventricular circulation time in physically trained and untrained subjects. European Journal of Applied Physiology and Occupational Physiology 40 211–218. (doi:10.1007/BF00426943)

Hoogslag GE, Hoke U, Thijssen J, Auger D, Marsan NA, Wolterbeek R, Holman ER, Schalij MJ, Bax JJ, Verwey HF, et al. 2013 Clinical, echocardiographic, and neurohormonal response to cardiac resynchronization therapy: are they interchangeable? Pacing and Clinical Electrophysiology 36 1391–1401. (doi:10.1111/pace.12214)

Magne J, Dubois M, Champagne J, Dumesnil JG, Pibarot P, Philippon F, O’Hara G & Senechal M 2009 Usefulness of NT-pro BNP monitoring to identify echocardiographic responders following cardiac resynchronization therapy. Cardiovascular Ultrasound 7 39. (doi:10.1186/1476-7120-7-39)

Swift AJ, Telfer A, Rajaram S, Condliffe R, Marshall H, Capener D, Hurdman J, Elliot C, Kiely DG & Wild JM 2014 Dynamic contrast-enhanced magnetic resonance imaging in patients with pulmonary arterial hypertension. Pulmonary Circulation 4 61–70. (doi:10.1086/674882)

Thông tin
Thông tin xuất bản

Echo Research and Practice

Tập 3 Số 2

35-43

Thông tin tác giả