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Volume calibration with cardiac MRI versus hypertonic saline for right ventricular pressure-volume loops with exercise: Impact on ventricular function and ventricular-vascular coupling.
The Journal of Heart and Lung Transplantation ( IF 6.4 ) Pub Date : 2024-10-28 , DOI: 10.1016/j.healun.2024.10.018
Farhan Raza,Chris G Lechuga,Oliver Wieben,Naomi C Chesler

BACKGROUND Right ventricular (RV) pressure-volume (PV) loops require postacquisition volume calibration by cardiac MRI (CMR) or hypertonic saline (HS). We defined the impact of these 2 volume calibration methods on rest-to-exercise ventricular contractility (end-systolic elastance: Ees), arterial afterload (Ea), and coupling (Ees/Ea). METHODS In a prospective study, 82 RV PV-loop datapoints (rest, exercise stages every 25 W, and recovery) and CMR were acquired in 19 participants. RESULTS In comparison to CMR, HS-based calibration overestimated RV end-systolic volume at rest, mean (SD) by +38 ml (48) and end-diastolic volume by +46 ml (68), resulting in underestimated right ventricular ejection fraction (RVEF) by -8%. However, Ees and Ea were similar at rest (r2 = 0.76 and 0.71, respectively, p < 0.001 for both), and Ees:Ea was identical (r2 = 1.00, p < 0.001). Exercise metrics also remained similar: RV reserve (ΔEes) and change in coupling (ΔEes/Ea). CONCLUSIONS In comparison to CMR (gold-standard), HS-based calibration underestimates RVEF at rest; however, it is a robust approach for measuring coupling and RV reserve.

中文翻译:


心脏 MRI 与高渗盐水对运动时右心室压力-容量环的容量校准:对心室功能和心室-血管耦合的影响。



背景 右心室 (RV) 压力-容积 (PV) 环需要通过心脏 MRI (CMR) 或高渗盐水 (HS) 进行采集后容量校准。我们定义了这 2 种容量校准方法对静息到运动心室收缩力 (收缩末期弹性: Ees) 、动脉后负荷 (Ea) 和耦合 (Ees/Ea) 的影响。方法 在一项前瞻性研究中,82 名参与者获得了 19 个 RV PV 回路数据点(休息、每 25 W 运动阶段和恢复)和 CMR。结果 与 CMR 相比,基于 HS 的校准高估了静息时 RV 收缩末期容积、平均值 (SD) +38 ml (48) 和舒张末期容积 +46 ml (68),导致右心室射血分数 (RVEF) 低估了 -8%。然而,Ees 和 Ea 在静止时相似 (r2 = 0.76 和 0.71,两者的 p < 0.001),并且 Ees:Ea 相同 (r2 = 1.00,p < 0.001)。运动指标也保持相似:RV 储备 (ΔEes) 和耦合变化 (ΔEes/Ea)。结论与 CMR (金标准) 相比,基于 HS 的校准低估了静息时的 RVEF;然而,它是测量耦合和 RV 储备的可靠方法。
更新日期:2024-10-28
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