Echocardiographic surrogate of left ventricular stroke work in a model of brain stem death donors

IF 4.4 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Clinical Investigation Pub Date : 2024-06-06 DOI:10.1111/eci.14259

Kei Sato, Louise See Hoe, Jonathan Chan, Nchafatso G. Obonyo, Karin Wildi, Silver Heinsar, Sebastiano M. Colombo, Carmen Ainola, Gabriella Abbate, Noriko Sato, Margaret R. Passmore, Mahe Bouquet, Emily S. Wilson, Kieran Hyslop, Samantha Livingstone, Andrew Haymet, Jae-Seung Jung, Kris Skeggs, Chiara Palmieri, Nicole White, David Platts, Jacky Y. Suen, David C. McGiffin, Gianluigi Li Bassi, John F. Fraser

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引用次数: 0

Abstract

Background

The commonest echocardiographic measurement, left ventricular ejection fraction, can not necessarily predict mortality of recipients following heart transplantation potentially due to afterload dependency. Afterload-independent left ventricular stroke work index (LVSWI) is alternatively recommended by the current guideline; however, pulmonary artery catheters are rarely inserted in organ donors in most jurisdictions. We propose a novel non-invasive echocardiographic parameter, Pressure-Strain Product (PSP), as a potential surrogate of catheter-based LVSWI. This study aimed to investigate if PSP could correlate with catheter-based LVSWI in an ovine model of brain stem death (BSD) donors. The association between PSP and myocardial mitochondrial function in the post-transplant hearts was also evaluated.

Methods

Thirty-one female sheep (weight 47 ± 5 kg) were divided into two groups; BSD (n = 15), and sham neurologic injury (n = 16). Echocardiographic parameters including global circumferential strain (GCS) and global radial strain (GRS) and pulmonary artery catheter-based LVSWI were simultaneously measured at 8-timepoints during 24-h observation. PSP was calculated as a product of GCS or GRS, and mean arterial pressure for PSP_circ or PSP_rad, respectively. Myocardial mitochondrial function was evaluated following 6-h observation after heart transplantation.

Results

In BSD donor hearts, PSP_circ (n = 96, rho = .547, p < .001) showed the best correlation with LVSWI among other echocardiographic parameters. PSP_circ returned AUC of .825 to distinguish higher values of cardiomyocyte mitochondrial function (cut-off point; mean value of complex 1,2 O₂ Flux) in post-transplant hearts, which was greater than other echocardiographic parameters.

Conclusions

PSP_circ could be used as a surrogate of catheter-based LVSWI reflecting mitochondrial function.

Abstract Image

查看原文本刊更多论文

脑干死亡供体模型中左心室卒中功的超声心动图替代物。

背景：最常见的超声心动图测量方法--左心室射血分数并不一定能预测心脏移植后受者的死亡率，这可能是由于后负荷依赖性所致。目前的指南推荐使用与后负荷无关的左心室搏动功指数（LVSWI），但在大多数地区，很少为器官捐献者植入肺动脉导管。我们提出了一种新的无创超声心动图参数--压力应变积（PSP），作为导管式 LVSWI 的潜在替代指标。本研究旨在探讨在脑干死亡（BSD）供体的绵羊模型中，PSP 是否与导管法 LVSWI 相关。研究还评估了PSP与移植后心脏的心肌线粒体功能之间的关联：方法：31 只雌性绵羊（体重 47 ± 5 千克）分为两组：BSD 组（n = 15）和假性神经损伤组（n = 16）。在 24 小时观察期间，在 8 个时间点同时测量超声心动图参数，包括全周应变 (GCS) 和全径向应变 (GRS)，以及基于肺动脉导管的 LVSWI。PSP分别以GCS或GRS与平均动脉压的乘积来计算PSPcirc或PSPrad。心脏移植后观察 6 小时后评估心肌线粒体功能：结果：在 BSD 供体心脏中，PSPcirc（n = 96，rho = .547，p circ 返回 AUC 为 .825，可区分移植后心脏中较高值的心肌细胞线粒体功能（临界点；1,2 氧通量复合体的平均值），其值高于其他超声心动图参数：结论：PSPcirc 可作为导管法 LVSWI 的替代指标，反映线粒体功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Investigation 医学-医学：内科

CiteScore

9.50

自引率

3.60%

发文量

192

审稿时长

1 months

期刊介绍： EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.