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Mode M color-Doppler imaging post-processing provides a good left ventricular contractility index
International Congress Series 1281 (2005) 1294
Mode M color-Doppler imaging post-processing provides a good left ventricular contractility index J.C. Antoranza,T, M.M. Descoa, R. Yottia, J. Bermejoa, C. Cortinaa, J.L. Rojob a
Hospital General Universitario Gregorio Maran˜o´n, Madrid, Spain b Universidad Carlos III, Legane´s, Madrid, Spain
1. Introduction Invasive indices of myocardial contractility (MC) based on the left ventricular pressure–volume relationship are quantitative, reproducible, accurate, and load-independent. They are considered as the most appropriated standards of contractility available in vivo. Active force of the contracting myocardium produces pressure gradients. Intraventricular ejection pressure gradients have been invasively measured as instantaneous ejection intraventricular pressure differences (IEIPD) between the apex and left ventricular outflow tract and related to the inotropic state. We proposed a new method that provides accurate and reproducible non-invasive measurements of the IEIPD by postprocessing color-Doppler M-mode images [1]. 2. Method We have used 9 Minipigs with an open-chest close-pericardium model. A conductance–pressure catheter was placed into the left ventricle. Indices of contractility derived from the pressure–volume loops obtained during caval occlusion were maximum elastance (Emax) and preload recruitable stroke work (PRSW). We have used an echocardiograph Sequoia C-256. The color-Doppler M-mode image provides the data to solve Euler’s equation and IEIPD. Animals were studied at baseline, during esmolol and dobutamine infusions, and after left main coronary microembolization. 3. Results A wide range of inotropic states was achieved. Peak IEIPD closely correlates with all the invasive indices of contractility. IEIPD are as sensitive as Emax and PRSW. Then, Doppler derived IEIPD provide quantitative, reproducible, non-invasive indices of global MC that closely correlate with currently reference methods available in vivo. Reference [1] Yotti Raquel, et al., Noninvasive assessment of ejection intraventricular pressure gradients, J. Am. Coll. Cardiol. 43 (9) (2004) 1654 – 1662. T Corresponding author. E-mail address: [email protected] (J.C. Antoranz). 0531-5131/ D 2005 CARS & Elsevier B.V. All rights reserved. doi:10.1016/j.ics.2005.03.059
Mode M color-Doppler imaging post-processing provides a good left ventricular contractility index J.C. Antoranza,T, M.M. Descoa, R. Yottia, J. Bermejoa, C. Cortinaa, J.L. Rojob a
Hospital General Universitario Gregorio Maran˜o´n, Madrid, Spain b Universidad Carlos III, Legane´s, Madrid, Spain
1. Introduction Invasive indices of myocardial contractility (MC) based on the left ventricular pressure–volume relationship are quantitative, reproducible, accurate, and load-independent. They are considered as the most appropriated standards of contractility available in vivo. Active force of the contracting myocardium produces pressure gradients. Intraventricular ejection pressure gradients have been invasively measured as instantaneous ejection intraventricular pressure differences (IEIPD) between the apex and left ventricular outflow tract and related to the inotropic state. We proposed a new method that provides accurate and reproducible non-invasive measurements of the IEIPD by postprocessing color-Doppler M-mode images [1]. 2. Method We have used 9 Minipigs with an open-chest close-pericardium model. A conductance–pressure catheter was placed into the left ventricle. Indices of contractility derived from the pressure–volume loops obtained during caval occlusion were maximum elastance (Emax) and preload recruitable stroke work (PRSW). We have used an echocardiograph Sequoia C-256. The color-Doppler M-mode image provides the data to solve Euler’s equation and IEIPD. Animals were studied at baseline, during esmolol and dobutamine infusions, and after left main coronary microembolization. 3. Results A wide range of inotropic states was achieved. Peak IEIPD closely correlates with all the invasive indices of contractility. IEIPD are as sensitive as Emax and PRSW. Then, Doppler derived IEIPD provide quantitative, reproducible, non-invasive indices of global MC that closely correlate with currently reference methods available in vivo. Reference [1] Yotti Raquel, et al., Noninvasive assessment of ejection intraventricular pressure gradients, J. Am. Coll. Cardiol. 43 (9) (2004) 1654 – 1662. T Corresponding author. E-mail address: [email protected] (J.C. Antoranz). 0531-5131/ D 2005 CARS & Elsevier B.V. All rights reserved. doi:10.1016/j.ics.2005.03.059