Estimation of Pulmonary Arterial Wave Reflection by Echo-Doppler: A Preliminary Study in Dogs With Experimentally-Induced Acute Pulmonary Embolism.


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Yoshida T., Uejima T., Komeda S., Matsuura K., Uemura A., Hayama H., ...Daha Fazla

Frontiers in physiology, cilt.12, ss.752550, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 12
  • Basım Tarihi: 2021
  • Doi Numarası: 10.3389/fphys.2021.752550
  • Dergi Adı: Frontiers in physiology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.752550
  • Anahtar Kelimeler: pulmonary hypertension, wave separation analysis, wave reflection, Doppler echocardiography, wave intensity analysis, VASCULAR-RESISTANCE, HYPERTENSION, PRESSURE, TIME, ECHOCARDIOGRAPHY, DIAGNOSIS, ENVELOPE, FRACTION, SHAPE
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

Background: Pulmonary arterial (PA) wave reflection provides additional information for assessing right ventricular afterload, but its applications is hampered by the need for invasive pressure and flow measurements. We tested the hypothesis that PA pressure and flow waveforms estimated by Doppler echocardiography could be used to quantify PA wave reflection.Methods: Doppler echocardiographic images of tricuspid regurgitation and right ventricular outflow tract flow used to estimate PA pressure and flow waveforms were acquired simultaneously with direct measurements with a dual sensor-tipped catheter under various hemodynamic conditions in a canine model of pulmonary hypertension (n = 8). Wave separation analysis was performed on echo-Doppler derived as well as catheter derived waveforms to separate PA pressure into forward (Pf) and backward (Pb) pressures and derive wave reflection coefficient (RC) defined as the ratio of peak Pb to peak Pf.Results: Wave reflection indices by echo-Doppler agreed well with corresponding indices by catheter (Pb: mean difference = 0.4 mmHg, 95% limits of agreement = -4.3 to 5.0 mmHg; RC: bias = 0.13, 95% limits of agreement = -0.25 to 0.26). RC correlated negatively with PA compliance.Conclusion: This echo-Doppler method yields reasonable measurement of reflected wave in the pulmonary circulation, paving the way to a more integrative assessment of pulmonary hemodynamics in the clinical setting.