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Combination of Real Time Three‐Dimensional Echocardiography with Diagnostic Catheterization to Derive Left Ventricular Pressure‐Volume Relations
Author(s) -
Kutty Shelby,
Li Ling,
Padiyath Asif,
Gribben Paul,
Gao Shunji,
Lof John,
Bidasee Keshore R.,
Danford David A.,
Kuehne Titus
Publication year - 2014
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12326
Subject(s) - dobutamine , cardiac catheterization , medicine , contractility , cardiology , catheter , ventricular pressure , anesthesia , hemodynamics , surgery
Aims The aim of this study was to investigate the left ventricular ( LV ) myocardial contractility index‐Emax using transesophageal real time three‐dimensional echocardiography ( RT3DE ) combined with catheterization. Methods Transesophageal RT3DE (single beat, X7‐2 × matrix, iE33, Philips) was used to obtain real time LV volumes in pigs. Volumes were integrated with LV pressures from conductance catheterization ( CC ) to create RT3DE pressure‐volume relations. At the same time, CC was used for measuring conventional pressure‐volume relations that served as reference. The slope Emax was determined from RT3DE and CC end‐systolic pressure‐volume relations. All measurements were made at rest and during dobutamine infusion. Results In six pigs, the mean ± SD (mmHg/mL) values were Emax‐ CC 1.86 ± 1.1 and Emax‐ RT3DE 1.78 ± 1.2 (P = 0.502) at baseline. On dobutamine, mean Emax‐ CC was 3.43 ± 1.5 and Emax‐ RT3DE 3.60 ± 1.23 (P = 0.171). Bland–Altman analysis showed good agreements between the RT3DE ‐ and CC ‐derived Emax for measurements performed at baseline and on dobutamine. Conclusions 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.