血管外肺水特征-心血管磁共振双造影剂细胞外容积入路。

IF 6.1 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Felicia Seemann, Rim N Halaby, Andrea Jaimes, Kendall O'Brien, Peter Kellman, Daniel A Herzka, Robert J Lederman, Adrienne E Campbell-Washburn
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引用次数: 0

摘要

病理性血管外肺水是失代偿性充血性心力衰竭的一个方面,目前的心血管磁共振(CMR)方法无法量化。CMR可以测量肺总水密度,但不能区分血管内和血管外液体,因此不能诊断。因此,我们开发并评估了一种测量血管外肺水的新方法,通过使用两种不同的造影剂,细胞外钆螯合物和铁基血管内阿魏木醇,来区分血管内和细胞外液体区室。材料和方法:我们建立了两种猪肺水肿模型:导管诱导的可逆性二尖瓣反流诱导血管外肺水(n=5);使用快速胶体输注使血管内容量过载(n=5);与正常对照(n=8)相比。我们依次获得了0.55T时的肺t1图和肺水密度图,分别采用天然造影剂、钆造影剂和阿魏木糖醇造影剂,以此计算肺组织中的细胞外体积(ECV)和血浆体积分数。我们计算血管外ECV作为ECV和血浆体积分数的差异。估计肺血管外水容量。结果:在二尖瓣反流模型中,基线组与二尖瓣反流组相比,血管外ecv由27±4.1%增加到32±1.9% (p=0.006),血管外肺水量由105±19ml增加到143±15ml (p=0.048)。血浆体积分数基线与二尖瓣反流相似(43±4.2% vs 46±5.4%,p=0.26)。与naïve猪相比,我们在血管内容量负荷模型中测量到更高的血浆体积分数(42±4.7% vs 51±2.7%,p=0.0054),但在ecv血管外(21±4.6% vs 21±3.6%,p=0.99)或血管外肺水容量(67±13ml vs 89±24ml, p=0.11)没有差异。从区域分布上看,血浆体积后侧较高,提示重力依赖性,而肺血管外水前侧较高。结论:在动物模型中,血管外肺ECV测量值和导出的肺水量与预测的血管外和血管内肺液的增加相吻合。该方法可用于呼吸困难患者肺水的机理研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterizing extravascular lung water-A dual-contrast agent extracellular volume approach by cardiovascular magnetic resonance.

Background: Pathological extravascular lung water is a facet of decompensated congestive heart failure that current cardiovascular magnetic resonance (CMR) methods fail to quantify. CMR can measure total lung water density, but cannot distinguish between intravascular and extravascular fluid, and thus is not diagnostic. Therefore, we develop and evaluate a novel method to measure extravascular lung water by distinguishing intravascular from extracellular fluid compartments using two different contrast agents, extracellular gadolinium chelates and iron-based intravascular ferumoxytol.

Methods: We created two porcine models of pulmonary edema: reversible catheter-induced mitral regurgitation to induce extravascular lung water (n = 5); intravascular volume overload using rapid colloid infusion (n = 5); and compared to normal controls (n = 8). We sequentially acquired lung T1 maps and lung water density maps at 0.55T with native, gadolinium-based, and ferumoxytol contrast, from which we calculated the extracellular volume fraction (ECV) and blood plasma volume fraction in the pulmonary tissue, respectively. We computed extravascular ECV as the difference in ECV and plasma volume fractions. Extravascular lung water volumes were estimated.

Results: In the mitral regurgitation model, baseline vs mitral regurgitation ECVextravascular increased from 27 ± 4.1% to 32 ± 1.9% (p = 0.006), and extravascular lung water volume increased from 105 ± 19 mL to 143 ± 15 mL (p = 0.048). Plasma volume fraction was similar at baseline vs mitral regurgitation (43 ± 4.2% vs 46 ± 5.4%, p = 0.26). Compared to naïve pigs, we measured higher plasma volume fractions in the intravascular volume-loaded model (42 ± 4.7% vs 51 ± 2.7%, p = 0.0054), but no differences in ECVextravascular (21 ± 4.6% vs 21 ± 3.6%, p = 0.99) or extravascular lung water volume (67 ± 13 mL vs 89 ± 24 mL, p = 0.11). Assessing the regional distribution, the plasma volume was higher posteriorly, indicating gravitational dependency, whereas, the extravascular lung water was higher anteriorly.

Conclusion: Extravascular lung ECV measurements and derived lung water volumes corresponded well with predicted increases in extravascular and intravascular pulmonary fluid in animal models. This method may enable mechanistic studies of lung water in patients with dyspnea.

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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.
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