Evaluation of Intracardiac Pressures Using Subharmonic-aided Pressure Estimation with Sonazoid Microbubbles.
Cara Esposito, Priscilla Machado, Maureen E McDonald, Michael P Savage, David Fischman, Praveen Mehrotra, Ira S Cohen, Nicholas Ruggiero, Paul Walinsky, Alec Vishnevsky, Kristopher Dickie, Marguerite Davis, Flemming Forsberg, Jaydev K Dave
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Abstract
Purpose To investigate if the right ventricular (RV) systolic and left ventricular (LV) diastolic pressures can be obtained noninvasively using the subharmonic-aided pressure estimation (SHAPE) technique with Sonazoid microbubbles. Materials and Methods Individuals scheduled for a left and/or right heart catheterization were prospectively enrolled in this institutional review board-approved clinical trial from 2017 to 2020. A standard-of-care catheterization procedure was performed by advancing fluid-filled pressure catheters into the LV and aorta (n = 25) or RV (n = 22), and solid-state high-fidelity pressure catheters into the LV and aorta in a subset of participants (n = 18). Study participants received an infusion of Sonazoid microbubbles (GE HealthCare), and SHAPE data were acquired using a validated interface developed on a SonixTablet (BK Medical) US scanner, synchronously with the pressure catheter data. A conversion factor, derived using cuff-based pressure measurements with a SphygmoCor XCEL PWA (ATCOR) and subharmonic signal from the aorta, was used to convert the subharmonic signal into pressure values. Errors between the pressure measurements obtained using the SHAPE technique and pressure catheter were compared. Results The mean errors in pressure measurements obtained with the SHAPE technique relative to those of the fluid-filled pressure catheter were 1.6 mm Hg ± 1.5 [SD] (P = .85), 8.4 mm Hg ± 6.2 (P = .04), and 7.4 mm Hg ± 5.7 (P = .09) for RV systolic, LV minimum diastolic, and LV end-diastolic pressures, respectively. Relative to the measurements with the solid-state high-fidelity pressure catheter, the mean errors in LV minimum diastolic and LV end-diastolic pressures were 7.2 mm Hg ± 4.5 and 6.8 mm Hg ± 3.3 (P ≥ .44), respectively. Conclusion These results indicate that SHAPE with Sonazoid may have the potential to provide clinically relevant RV systolic and LV diastolic pressures. Keywords: Ultrasound-Contrast, Cardiac, Aorta, Left Ventricle, Right Ventricle ClinicalTrials.gov registration no.: NCT03245255 © RSNA, 2024.
利用 Sonazoid 微气泡的次谐波辅助压力估算评估心内压
目的 研究是否可以通过使用 Sonazoid 微气泡的次谐波辅助压力估算(SHAPE)技术无创获取右心室(RV)收缩压和左心室(LV)舒张压。材料与方法 2017 年至 2020 年期间,计划接受左心导管和/或右心导管检查的个人前瞻性地加入了这项经机构审查委员会批准的临床试验。通过将充液压力导管推进左心室和主动脉(n = 25)或右心室(n = 22),以及将固态高保真压力导管推进左心室和主动脉,对一部分参与者(n = 18)进行了标准护理导管检查。研究参与者输注 Sonazoid 微气泡(GE HealthCare),使用在 SonixTablet(BK Medical)US 扫描仪上开发的有效界面获取 SHAPE 数据,并与压力导管数据同步。使用 SphygmoCor XCEL PWA(ATCOR)和主动脉次谐波信号进行袖带压力测量,得出一个转换系数,用于将次谐波信号转换为压力值。比较了使用 SHAPE 技术和压力导管获得的压力测量值之间的误差。结果 相对于充液压力导管,SHAPE 技术获得的压力测量平均误差分别为 1.6 mm Hg ± 1.5 [SD] (P = .85)、8.4 mm Hg ± 6.2 (P = .04) 和 7.4 mm Hg ± 5.7 (P = .09)(左心室收缩压、左心室最低舒张压和左心室舒张末压)。相对于使用固态高保真压力导管进行的测量,左心室最小舒张压和左心室舒张末期压的平均误差分别为 7.2 mm Hg ± 4.5 和 6.8 mm Hg ± 3.3(P ≥ .44)。结论 这些结果表明,使用 Sonazoid 的 SHAPE 有可能提供与临床相关的 RV 收缩压和 LV 舒张压。关键词超声对比 心脏 主动脉 左心室 右心室 ClinicalTrials.gov 注册号:NCT03245255 © RSNA, 2024.
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