Intraventricular Pressure Difference by Blood Speckle Tracking - Invasive Validation and Clinical Application

Kristian Soerensen, Solveig Fadnes, Wadi Mawad, Matthew Henry, Hans Martin Flade, Andreas Østvik, Tor Åge Myklebust, Idar Kirkeby-Garstad, Lasse Løvstakken, Luc Mertens, Siri Ann Nyrnes
{"title":"Intraventricular Pressure Difference by Blood Speckle Tracking - Invasive Validation and Clinical Application","authors":"Kristian Soerensen, Solveig Fadnes, Wadi Mawad, Matthew Henry, Hans Martin Flade, Andreas Østvik, Tor Åge Myklebust, Idar Kirkeby-Garstad, Lasse Løvstakken, Luc Mertens, Siri Ann Nyrnes","doi":"10.1101/2024.08.20.24312326","DOIUrl":null,"url":null,"abstract":"Background Early diastolic relaxation creates an intraventricular pressure difference (IVPD) and resulting diastolic suction. Non-invasive estimation by echocardiographic techniques would allow to clinically evaluate this IVPD as an important component of ventricular filling. Recently, Blood Speckle Tracking (BST) echocardiography was introduced, allowing two-dimensional assessment of ventricular flow dynamics. Mitral inflow BST data can be used to estimate IVPD. The aims of the current study were to evaluate the accuracy of BST-based IVPD estimation compared to invasive pressure measurements in an in vivo animal model, and to clinically apply the method by comparing IVPD in children with univentricular hearts (UVH) and healthy controls. Methods The accuracy of BST-based IVPD-estimates was assessed in an open-chest porcine model, comparing BST-based IVPD with simultaneous repeated invasive pressure measurements in six pigs using micromanometer catheters. BST-based IVPD assessment was performed in 120 healthy controls and 44 patients with UVH < 18 years of age. Total IVPD (from base to apex) and apical IVPD (from the apical 2/3 of the ventricle) during early diastolic filling of the systemic ventricle was compared between patients with UVH and healthy controls. Results The validation in pigs included 103 measurements, demonstrating a mean difference of -0.01mmHg (p=0.33) and high correlation (r = 0.95, p-value < 0.001) between IVPD from BST (-1.31 ± 0.28 mmHg) and invasive measurements (-1.30 ± 0.31 mmHg). In the pediatric patients, age range 2 days-17.76 years, feasibility was 96% in controls and 88.6% in UVH patients. Total and apical IVPD were significantly higher in controls compared to UVH (-1.82 vs -0.88 mmHg and -0.63 vs -0.33 mmHg, p < 0.001). Variability was low with intraclass correlation coefficients of 0.99/0.96 (interobserver) and 0.98/0.99 (intraobserver) for total and apical IVPD respectively.\nConclusions BST echocardiography provides accurate estimation of early diastolic IVPD. When clinically applied in children, we found high feasibility and reproducibility. IVPD was significantly lower in children with UVH compared to controls suggesting lower diastolic suction which can impact overall filling dynamics.","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"medRxiv - Cardiovascular Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1101/2024.08.20.24312326","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background Early diastolic relaxation creates an intraventricular pressure difference (IVPD) and resulting diastolic suction. Non-invasive estimation by echocardiographic techniques would allow to clinically evaluate this IVPD as an important component of ventricular filling. Recently, Blood Speckle Tracking (BST) echocardiography was introduced, allowing two-dimensional assessment of ventricular flow dynamics. Mitral inflow BST data can be used to estimate IVPD. The aims of the current study were to evaluate the accuracy of BST-based IVPD estimation compared to invasive pressure measurements in an in vivo animal model, and to clinically apply the method by comparing IVPD in children with univentricular hearts (UVH) and healthy controls. Methods The accuracy of BST-based IVPD-estimates was assessed in an open-chest porcine model, comparing BST-based IVPD with simultaneous repeated invasive pressure measurements in six pigs using micromanometer catheters. BST-based IVPD assessment was performed in 120 healthy controls and 44 patients with UVH < 18 years of age. Total IVPD (from base to apex) and apical IVPD (from the apical 2/3 of the ventricle) during early diastolic filling of the systemic ventricle was compared between patients with UVH and healthy controls. Results The validation in pigs included 103 measurements, demonstrating a mean difference of -0.01mmHg (p=0.33) and high correlation (r = 0.95, p-value < 0.001) between IVPD from BST (-1.31 ± 0.28 mmHg) and invasive measurements (-1.30 ± 0.31 mmHg). In the pediatric patients, age range 2 days-17.76 years, feasibility was 96% in controls and 88.6% in UVH patients. Total and apical IVPD were significantly higher in controls compared to UVH (-1.82 vs -0.88 mmHg and -0.63 vs -0.33 mmHg, p < 0.001). Variability was low with intraclass correlation coefficients of 0.99/0.96 (interobserver) and 0.98/0.99 (intraobserver) for total and apical IVPD respectively. Conclusions BST echocardiography provides accurate estimation of early diastolic IVPD. When clinically applied in children, we found high feasibility and reproducibility. IVPD was significantly lower in children with UVH compared to controls suggesting lower diastolic suction which can impact overall filling dynamics.
通过血液斑点跟踪测量脑室内压差 - 侵入式验证和临床应用
背景 舒张早期松弛会产生心室内压差(IVPD),从而导致舒张期抽吸。通过超声心动图技术进行无创估测,可对作为心室充盈重要组成部分的 IVPD 进行临床评估。最近推出的血液斑点追踪(BST)超声心动图可对心室血流动力学进行二维评估。二尖瓣流入道 BST 数据可用于估算 IVPD。本研究的目的是在体内动物模型中评估基于 BST 的 IVPD 估测与有创压力测量的准确性,并通过比较单心室儿童(UVH)和健康对照组的 IVPD,将该方法应用于临床。方法 在开胸猪模型中评估基于 BST 的 IVPD 估算值的准确性,将基于 BST 的 IVPD 估算值与同时使用微压计导管对六头猪进行的重复有创压力测量进行比较。对 120 名健康对照组和 44 名 18 岁紫外线辐射休克患者进行了基于 BST 的 IVPD 评估。比较了 UVH 患者和健康对照组在系统心室舒张早期充盈时的总 IVPD(从心底到心尖)和心尖 IVPD(从心尖 2/3 开始)。结果 猪的验证包括 103 次测量,显示平均差异为-0.01 mmHg(p=0.33),BST 的 IVPD(-1.31 ± 0.28 mmHg)与有创测量(-1.30 ± 0.31 mmHg)之间具有高度相关性(r = 0.95,p 值为 0.001)。在年龄为 2 天-17.76 岁的儿童患者中,对照组的可行性为 96%,紫外线辐射病患者的可行性为 88.6%。与 UVH 相比,对照组的总 IVPD 和心尖 IVPD 明显更高(-1.82 vs -0.88 mmHg 和 -0.63 vs -0.33 mmHg,p < 0.001)。总 IVPD 和心尖 IVPD 的类内相关系数分别为 0.99/0.96(观察者间)和 0.98/0.99(观察者内),变异性较低。结论 BST 超声心动图能准确估测舒张早期 IVPD,在儿童临床应用时,我们发现其可行性和可重复性都很高。与对照组相比,UVH患儿的IVPD明显较低,这表明舒张期的吸力较低,会影响整体充盈动力学。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信