Thorac Cardiovasc Surg 2015; 63 - OP152
DOI: 10.1055/s-0035-1544404

Validation of Pressure Volume Relations Derived from 3D Real-Time Echocardiography and Mini Pressure Wire in Piglets

U. Herberg 1, D. Ladage 2, G. D. Dürr 3, K. Linden 1, E. Gatzweiler 1, M. Seehase 1, J. Dörner 4, J. Breuer 1, O. Dewald 3
  • 1Universitätsklinikum Bonn, Kinderkardiologie, Bonn, Germany
  • 2Universitätsklinikum Köln, Kardiologie, Köln, Germany
  • 3Universitätsklinikum Bonn, Klinik und Poliklinik für Herzchirurgie, Bonn, Germany
  • 4Universitätsklinikum Bonn, Radiologie, Bonn, Germany

Background: Pressure-volume relations (PVR) provide vital information regarding ventricular performance and cardiac pathophysiology. However, in children acquisition of PVR by conductance-technology is - due to catheter size and invasiveness - restricted to an older age.

Objectives: The aim of the study was to validate the accuracy of minimal invasive assessment of PVR in small hearts using volume data obtained by real-time three-dimensional echocardiography (3D) and simultaneously acquired pressure data.

Methods: In 17 piglets (mean weight:5 0.9 ± 1.3 [range 3.6–8.0] kg) left ventricular PVR were generated by 3D in conjunction with simultaneously recording of left ventricular pressure using a mini pressure wire (PVR3D). PVR3D were compared with conductance catheter measurements (PVRCond) under various hemodynamic conditions: baseline, adrenergic stimulation (phenylephrine) and β-adrenoreceptor blockage (esmolol). In another 8 pigles, the accuracy of 3D volumetric data including volume changes over time was validated by cardiac magnetic resonance imaging (CMR) .

Results: Computation of PVR3D was feasible, reproducible and comparable to results obtained by conductance technology . Bland-Altman analysis showed a low bias between PVR3D and PVRCond for systolic (systolic myocardial elastance, arterial elastance dp/dtmax) and diastolic parameters (Tau, enddiastolic PVR, dp/dtmin). The dynamic changes under different hemodynamics conditions correlated well between the two methods (Fig. 1). Comparision of CMR and 3DE revealed excellent correlation (r = 0.8829). Inter- and intraobserver- coefficients of variation were below 5% for all parameters .

Conclusions: 3D echocardiography generated PVR represent a novel, feasible and reliable method to assess different conditions of cardiac function in small hearts. Due to its minimal invasive character this methodology may be implemented into daily practice and contribute to clinical decision making in this crucial age group.

Fig. 1