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Kang S, Chen J, Zhang H, Li G, Liu Y, Mei X, Zhu B, Ai X, Jiang S. Pulmonary Transit Time Assessment by CEUS in Healthy Rabbits: Feasibility, and the Effects of UCAs Dilution Concentration. ULTRASONIC IMAGING 2024; 46:178-185. [PMID: 38622911 DOI: 10.1177/01617346241246169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
To evaluate the inter-observer variability and the intra-observer repeatability of pulmonary transit time (PTT) measurement using contrast-enhanced ultrasound (CEUS) in healthy rabbits, and assess the effects of dilution concentration of ultrasound contrast agents (UCAs) on PTT. Thirteen healthy rabbits were selected, and five concentrations UCAs of 1:200, 1:100, 1:50, 1:10, and 1:1 were injected into the right ear vein. Five digital loops were obtained from the apical 4-chamber view. Four sonographers obtained PTT by plotting the TIC of right atrium (RA) and left atrium (LA) at two time points (T1 and T2). The frame counts of the first appearance of UCAs in RA and LA had excellent inter-observer agreement, with intra-class correlations (ICC) of 0.996, 0.988, respectively. The agreement of PTT among four observers was all good at five different concentrations, with an ICC of 0.758-0.873. The reproducibility of PTT obtained by four observers at T1 and T2 was performed well, with ICC of 0.888-0.961. The median inter-observer variability across 13 rabbits was 6.5% and the median variability within 14 days for 4 observers was 1.9%, 1.7%, 2.2%, 1.9%, respectively; The PTT of 13 healthy rabbits is 1.01 ± 0.18 second. The difference of PTT between five concentrations is statistically significant. The PTT obtained by a concentration of 1:200 and 1:100 were higher than that of 1:1, while there were no significantly differences in PTT of a concentration of 1:1, 1:10, and 1:50. PTT measured by CEUS in rabbits is feasible, with excellent inter-observer and intra-observer reliability and reproducibility, and dilution concentration of UCAs influences PTT results.
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Affiliation(s)
- Song Kang
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
- Department of ultrasound, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, China
| | - Jianfeng Chen
- Laboratory Animal Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - He Zhang
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Guangyin Li
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yingying Liu
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xue Mei
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Binyang Zhu
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xin Ai
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Shuangquan Jiang
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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de Maar JS, Zandvliet MMJM, Veraa S, Tobón Restrepo M, Moonen CTW, Deckers R. Ultrasound and Microbubbles Mediated Bleomycin Delivery in Feline Oral Squamous Cell Carcinoma—An In Vivo Veterinary Study. Pharmaceutics 2023; 15:pharmaceutics15041166. [PMID: 37111651 PMCID: PMC10142092 DOI: 10.3390/pharmaceutics15041166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
To investigate the feasibility and tolerability of ultrasound and microbubbles (USMB)-enhanced chemotherapy delivery for head and neck cancer, we performed a veterinary trial in feline companion animals with oral squamous cell carcinomas. Six cats were treated with a combination of bleomycin and USMB therapy three times, using the Pulse Wave Doppler mode on a clinical ultrasound system and EMA/FDA approved microbubbles. They were evaluated for adverse events, quality of life, tumour response and survival. Furthermore, tumour perfusion was monitored before and after USMB therapy using contrast-enhanced ultrasound (CEUS). USMB treatments were feasible and well tolerated. Among 5 cats treated with optimized US settings, 3 had stable disease at first, but showed disease progression 5 or 11 weeks after first treatment. One cat had progressive disease one week after the first treatment session, maintaining a stable disease thereafter. Eventually, all cats except one showed progressive disease, but each survived longer than the median overall survival time of 44 days reported in literature. CEUS performed immediately before and after USMB therapy suggested an increase in tumour perfusion based on an increase in median area under the curve (AUC) in 6 out of 12 evaluated treatment sessions. In this small hypothesis-generating study, USMB plus chemotherapy was feasible and well-tolerated in a feline companion animal model and showed potential for enhancing tumour perfusion in order to increase drug delivery. This could be a forward step toward clinical translation of USMB therapy to human patients with a clinical need for locally enhanced treatment.
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Affiliation(s)
- Josanne S. de Maar
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands
| | - Maurice M. J. M. Zandvliet
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
| | - Stefanie Veraa
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
| | - Mauricio Tobón Restrepo
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
| | - Chrit T. W. Moonen
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands
| | - Roel Deckers
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands
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Gleason HE, Phillips H, Fries R, Keating S, Hamel P, McCoy A. Ala vestibuloplasty improves cardiopulmonary and activity-related parameters in brachycephalic cats. Vet Surg 2023; 52:575-586. [PMID: 36882053 DOI: 10.1111/vsu.13948] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 12/08/2022] [Accepted: 02/15/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE To evaluate the effects of ala vestibuloplasty on cardiopulmonary and lifestyle-related parameters in brachycephalic (BC) cats. STUDY DESIGN Prospective cohort. ANIMALS Client-owned BC cats (n = 19). METHODS Cats were assessed preoperatively by airway computed tomography (CT), endoscopy, contrast echocardiography, cardiac biomarkers, and structured owner questionnaire. Ala vestibuloplasty was performed bilaterally, and blood values, imaging, and owner questionnaire responses were re-evaluated 8-20 weeks postoperatively. RESULTS Cats were presented for predominantly respiratory clinical signs attributable to brachycephaly. Preoperatively, all cats had stenotic nares, prolonged normalized pulmonary transit time (nPTT) (mean 5.43 ± 1.10 s), and a hyperattenuating pulmonary pattern. No complications occurred following surgery. Postoperatively, nPTT (mean 3.89 ± 0.74 s, p < .001) and frequencies of sneezing (p = .002), snoring (p = .006), open-mouth breathing (p = .0004), and nasal discharge (p = .019) were decreased. Cats exhibited increased activity (p = .005), less frequent dyspnea during activity (p < .001), longer duration of activity before becoming dyspneic (p = .002), faster recovery from activity (p < .001), and decreased respiratory noise (p < .001). Median questionnaire scores improved from preoperative to postoperative (p < .001). CONCLUSION Anatomic, echocardiographic, and CT changes were common in this cohort of clinically affected BC cats. Pulmonary blood flow and respiratory function were improved after surgery. CLINICAL SIGNIFICANCE Stenotic nares are the predominant airway abnormality in BC cats. Ala vestibuloplasty is a safe procedure that improves cardiac and CT abnormalities and respiratory and other clinical signs in BC cats.
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Affiliation(s)
- Hadley E Gleason
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Heidi Phillips
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Ryan Fries
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Stephanie Keating
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Phillip Hamel
- Boundary Bay Veterinary Specialty Hospital, Langley, British Columbia, Canada
| | - Annette McCoy
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
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Zhang J, Zheng XZ, Wu XC. Pulmonary transit time has close relation with pulmonary pulse wave transit time in normal subjects. Clin Physiol Funct Imaging 2023; 43:78-84. [PMID: 36377619 DOI: 10.1111/cpf.12794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/06/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pulmonary transit time (PTT) and pulmonary pulse wave transit time (pPTT) are useful parameters for the evaluation of cardiopulmonary circulation and vascular alterations, but their relationship remains unknown. The aim of this study was to investigate the correlation between PTT and pPTT. METHODS A total of 60 healthy volunteers were involved in this study. They were divided into two groups (30 participants per group): <50 years and >50 years. They all underwent Doppler echocardiography of pulmonary vein flow and contrast echocardiography with the measurement of pPTT and PTT, respectively. The correlation between PTT and pPTT was deduced. RESULTS Compared with Group of <50 years, there was a significant increment in left atrial volume index, left atrial pressure and pulmonary artery stiffness but a significant reduction in acceleration times of pulmonary artery flow in Group of >50 years (p < 0.05). Group >50 years had longer PTT and but reduced normalized PTT by R-R interval (NPTT), reduced normalized pPTT by R-R interval (NpPTT) than Group <50 years (p < 0.05), while there was no significant difference in pPTT between the two groups (p > 0.05). PTT and NPTT were all negatively correlated with pPTT and NpPTT. The statistically significant strongest correlation was observed between PTT and NpPTT (r = -0.886, p < 0.0001). The regression equation for them was y = 7.4396-13.095x (R2 = 0.785; p < 0.001), where x and y represent NpPTT and PTT, respectively. CONCLUSION PTT had close relation with pPTT in normal subjects. From the regression equation for them, we can get the value of PTT simply and easily by non-invasively measured pPTT.
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Affiliation(s)
- Jun Zhang
- Department of Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Xiao-Zhi Zheng
- Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Xu-Chu Wu
- Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
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de Lepper AG, Herold IH, Saporito S, Bouwman RA, Mischi M, Korsten HH, Reesink KD, Houthuizen P. Noninvasive pulmonary transit time: A new parameter for general cardiac performance. Echocardiography 2017; 34:1138-1145. [DOI: 10.1111/echo.13590] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Anouk G.W. de Lepper
- Department of Cardiology; Catharina Hospital Eindhoven; Eindhoven The Netherlands
| | - Ingeborg H.F. Herold
- Department of Anesthesiology and Intensive-Care; Catharina Hospital Eindhoven; Eindhoven The Netherlands
| | - Salvatore Saporito
- Department of Electrical Engineering; Signal Processing Systems; Eindhoven University of Technology; Eindhoven The Netherlands
| | - R. Arthur Bouwman
- Department of Anesthesiology and Intensive-Care; Catharina Hospital Eindhoven; Eindhoven The Netherlands
| | - Massimo Mischi
- Department of Electrical Engineering; Signal Processing Systems; Eindhoven University of Technology; Eindhoven The Netherlands
| | - Hendrikus H.M. Korsten
- Department of Anesthesiology and Intensive-Care; Catharina Hospital Eindhoven; Eindhoven The Netherlands
- Department of Electrical Engineering; Signal Processing Systems; Eindhoven University of Technology; Eindhoven The Netherlands
| | - Koen D. Reesink
- Department of Biomedical Engineering; CARIM School for Cardiovascular Diseases; Maastricht University; Maastricht The Netherlands
| | - Patrick Houthuizen
- Department of Cardiology; Catharina Hospital Eindhoven; Eindhoven The Netherlands
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Apple SM, Menciotti G, Braz-Ruivo L, Crosara S, Häggström J, Borgarelli M. Effects of pimobendan on myocardial perfusion and pulmonary transit time in dogs with myxomatous mitral valve disease: a pilot study. Aust Vet J 2016; 94:324-8. [DOI: 10.1111/avj.12480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/23/2015] [Accepted: 12/11/2015] [Indexed: 11/27/2022]
Affiliation(s)
- SM Apple
- Department of Small Animal Clinical Sciences; Virginia-Maryland College of Veterinary Medicine; Blacksburg VA 24060 USA
| | - G Menciotti
- Department of Small Animal Clinical Sciences; Virginia-Maryland College of Veterinary Medicine; Blacksburg VA 24060 USA
| | - L Braz-Ruivo
- Dogs and Cats Veterinary Referral & ER; Bowie MD USA
| | - S Crosara
- Department of Veterinary Science; University of Parma; Parma Italy
| | - J Häggström
- Department of Clinical Sciences; Swedish University of Agricultural Science; Uppsala Sweden
| | - M Borgarelli
- Department of Small Animal Clinical Sciences; Virginia-Maryland College of Veterinary Medicine; Blacksburg VA 24060 USA
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Herold IHF, Saporito S, Mischi M, van Assen HC, Bouwman RA, de Lepper AGW, van den Bosch HCM, Korsten HHM, Houthuizen P. Pulmonary transit time measurement by contrast-enhanced ultrasound in left ventricular dyssynchrony. Echo Res Pract 2016; 3:35-43. [PMID: 27249553 PMCID: PMC4989099 DOI: 10.1530/erp-16-0011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 05/16/2016] [Indexed: 11/08/2022] Open
Abstract
Background Pulmonary transit time (PTT) is an indirect measure of preload and left ventricular function, which can be estimated using the indicator dilution theory by contrast-enhanced ultrasound (CEUS). In this study, we first assessed the accuracy of PTT-CEUS by comparing it with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Secondly, we tested the hypothesis that PTT-CEUS correlates with the severity of heart failure, assessed by MRI and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Methods and results Twenty patients referred to our hospital for cardiac resynchronization therapy (CRT) were enrolled. DCE-MRI, CEUS, and NT-proBNP measurements were performed within an hour. Mean transit time (MTT) was obtained by estimating the time evolution of indicator concentration within regions of interest drawn in the right and left ventricles in video loops of DCE-MRI and CEUS. PTT was estimated as the difference of the left and right ventricular MTT. Normalized PTT (nPTT) was obtained by multiplication of PTT with the heart rate. Mean PTT-CEUS was 10.5±2.4s and PTT-DCE-MRI was 10.4±2.0s (P=0.88). The correlations of PTT and nPTT by CEUS and DCE-MRI were strong; r=0.75 (P=0.0001) and r=0.76 (P=0.0001), respectively. Bland–Altman analysis revealed a bias of 0.1s for PTT. nPTT-CEUS correlated moderately with left ventricle volumes. The correlations for PTT-CEUS and nPTT-CEUS were moderate to strong with NT-proBNP; r=0.54 (P=0.022) and r=0.68 (P=0.002), respectively. Conclusions (n)PTT-CEUS showed strong agreement with that by DCE-MRI. Given the good correlation with NT-proBNP level, (n)PTT-CEUS may provide a novel, clinically feasible measure to quantify the severity of heart failure. Clinical Trial Registry: NCT01735838
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Affiliation(s)
- Ingeborg H F Herold
- Department of Anesthesiology and Intensive-Care, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Salvatore Saporito
- Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Massimo Mischi
- Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Hans C van Assen
- Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - R Arthur Bouwman
- Department of Anesthesiology and Intensive-Care, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Anouk G W de Lepper
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | | | - Hendrikus H M Korsten
- Department of Anesthesiology and Intensive-Care, Catharina Hospital Eindhoven, Eindhoven, the Netherlands Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Patrick Houthuizen
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
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Herold IHF, Saporito S, Bouwman RA, Houthuizen P, van Assen HC, Mischi M, Korsten HHM. Reliability, repeatability, and reproducibility of pulmonary transit time assessment by contrast enhanced echocardiography. Cardiovasc Ultrasound 2016; 14:1. [PMID: 26729228 PMCID: PMC4700640 DOI: 10.1186/s12947-015-0044-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 12/22/2015] [Indexed: 01/08/2023] Open
Abstract
Background The aim of this study is to investigate the inter and intra-rater reliability, repeatability, and reproducibility of pulmonary transit time (PTT) measurement in patients using contrast enhanced ultrasound (CEUS), as an indirect measure of preload and left ventricular function. Methods Mean transit times (MTT) were measured by drawing a region of interest (ROI) in right and left cardiac ventricle in the CEUS loops. Acoustic intensity dilution curves were obtained from the ROIs. MTTs were calculated by applying model-based fitting on the dilution curves. PTT was calculated as the difference of the MTTs. Eight raters with different levels of experience measured the PTT (time moment 1) and repeated the measurement within a week (time moment 2). Reliability and agreement were assessed using intra-class correlations (ICC) and Bland-Altman analysis. Repeatability was tested by estimating the variance of means (ANOVA) of three injections in each patient at different doses. Reproducibility was tested by the ICC of the two time moments. Results Fifteen patients with heart failure were included. The mean PTT was 11.8 ± 3.1 s at time moment 1 and 11.7 ± 2.9 s at time moment 2. The inter-rater reliability for PTT was excellent (ICC = 0.94). The intra-rater reliability per rater was between 0.81–0.99. Bland-Altman analysis revealed a bias of 0.10 s within the rater groups. Reproducibility for PTT showed an ICC = 0.94 between the two time moments. ANOVA showed no significant difference between the means of the three different doses F = 0.048 (P = 0.95). The mean and standard deviation for PTT estimates at three different doses was 11.6 ± 3.3 s. Conclusions PTT estimation using CEUS shows a high inter- and intra-rater reliability, repeatability at three different doses, and reproducibility by ROI drawing. This makes the minimally invasive PTT measurement using contrast echocardiography ready for clinical evaluation in patients with heart failure and for preload estimation. Electronic supplementary material The online version of this article (doi:10.1186/s12947-015-0044-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ingeborg H F Herold
- Department of Anesthesiology and Intensive-Care, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
| | - Salvatore Saporito
- Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, De Zaale, 5612 AZ, Eindhoven, The Netherlands.
| | - R Arthur Bouwman
- Department of Anesthesiology and Intensive-Care, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
| | - Patrick Houthuizen
- Department of Cardiology, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
| | - Hans C van Assen
- Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, De Zaale, 5612 AZ, Eindhoven, The Netherlands.
| | - Massimo Mischi
- Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, De Zaale, 5612 AZ, Eindhoven, The Netherlands.
| | - Hendrikus H M Korsten
- Department of Anesthesiology and Intensive-Care, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands. .,Department of Electrical Engineering, Signal Processing Systems, Eindhoven University of Technology, De Zaale, 5612 AZ, Eindhoven, The Netherlands.
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Prütz M, Hungerbühler S, Laß M, Fehr M, Günther P, Mathes K. Contrast echocardiography for analysis of heart anatomy in tortoises. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2015; 43:231-7. [PMID: 26105200 DOI: 10.15654/tpk-140152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 01/29/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The cardiac anatomy in tortoises depicted on B-mode and color-Doppler should be better differentiated by additional contrast-echocardiography. MATERIAL AND METHODS An intravenous contrast agent (INN-sulphur hexafluoride [SonoVue®]) was injected in four tortoises (three Testudo hermanni, one Agrionemys horsfieldii), via the coccygeal vein, with parallel B-mode echocardiographic examination. The results of the contrast-enhanced echocardiography were compared with the contrast-free B-mode recordings and color-Doppler ultrasound. RESULTS The use of SonoVue® enabled clearer distinction of the cardiac structures, differentiation of the arising major arteries, identification of wash-out-shunts, and visualization of blood flow patterns throughout the tortoise heart. CONCLUSION AND CLINICAL RELEVANCE This study enables the accurate depiction and differentiation of cardiac anatomy in tortoises through the use of a combination of B-mode, color-Doppler and contrast-echocardiography. Basic knowledge of blood flow in the reptile heart is essential to understand echocardiographic anatomy. Blood-flow-patterns and anatomy of the tortoise heart as found in this study will help to establish a basis for further echocardiographic examinations of these animals.
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Affiliation(s)
- M Prütz
- Dr. Maike Prütz, Clinic for Pets, Reptiles, Pet and Feral Birds, University of Veterinary Medicine Hannover, Bünteweg 9, 30559 Hannover, Germany, E-Mail:
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Streitberger A, Modler P, Häggström J. Increased normalized pulmonary transit times and pulmonary blood volumes in cardiomyopathic cats with or without congestive heart failure. J Vet Cardiol 2015; 17:25-33. [PMID: 25837465 DOI: 10.1016/j.jvc.2014.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 09/15/2014] [Accepted: 09/26/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To estimate heart rate-normalized pulmonary transit times (nPTTs) in cardiomyopathic cats with or without congestive heart failure (CHF). To assess potential associations of echocardiographic variables and nPTT and to evaluate nPTT as a test for the presence of CHF. ANIMALS Forty-eight privately owned cats. METHODS nPTT was measured using echocardiography and the ultrasound contrast media SonoVue(®) in 3 groups of cats: healthy cats (group 1), cats with cardiomyopathy (CM) but without CHF (group 2), and cats with CM and CHF (group 3). Interrelations between pulmonary blood volume (PBV), nPTT, stroke volume (SV), and echocardiographic variables were investigated by means of linear univariate and multivariate analysis. RESULTS Median nPTT values in group 1, group 2, and group 3 were 3.63 (interquartile range [IQR], 3.20-4.22), 6.09 (IQR, 5.0-7.02), and 8.49 (IQR, 7.58-11.04), respectively. Values were significantly different between all 3 groups. Median PBVs in group 1, group 2, and group 3 were 27.94 mL (IQR, 21.02-33.17 mL), 42.83 mL (IQR, 38.46-50.36 mL) and 49.48 mL (IQR, 38.84-64.39 mL). SV, PBV, and shortening fraction <30% were significant predictors of nPTT. nPTT and left atrial to aortic root (LA:AO) ratio, not SV, were the main predictors of PBV. CONCLUSION nPTT may be useful as a test for the presence of CHF in cats with CM and as a measure of cardiac performance. nPTT and LA:AO ratios predict CHF with equal accuracy. Increased PBV is significantly associated with higher nPTT and LA:AO ratios.
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Affiliation(s)
- Andrea Streitberger
- Traunkreis Vet Clinic, Tierklinik Sattledt, Kirchdorferstraße 7, 4642 Sattledt, Austria.
| | - Peter Modler
- Traunkreis Vet Clinic, Tierklinik Sattledt, Kirchdorferstraße 7, 4642 Sattledt, Austria
| | - Jens Häggström
- Swedish University of Agricultural Sciences, Department of Clinical Sciences, P.O. Box 7070, 75007 Uppsala, Sweden
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Boronyak SM, Monahan K, Brittain EL, Merryman WD. An Inflection Point Method for the Determination of Pulmonary Transit Time From Contrast Echocardiography. IEEE Trans Biomed Eng 2015; 62:1853-61. [PMID: 25706506 DOI: 10.1109/tbme.2015.2405764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Indicator-dilution curves (IDCs) for the estimation of pulmonary transit times (PTTs) can be generated noninvasively using contrast echocardiography. Currently, these IDCs are analyzed by manual inspection, which is not feasible in a clinical setting, or fit to a statistical model to derive parameters of interest. However, IDCs generated from patients are frequently subject to significant low-frequency noise and recirculation artifacts that obscure the first-pass signal and render model fitting impractical or inaccurate. Thus, the objective of this paper was to develop alternative computational methods to determine PTT using noisy clinical data in which the signal decay is not adequately visible. METHODS We report on a method that uses a model fit to the rise portion of the IDCs to determine the signal inflection point. Additionally, a signal truncation algorithm was developed that enables automated analysis of the IDCs. RESULTS We compare PTTs derived from our inflection point method to those obtained by manual inspection in 25 patients (R(2) = 0.86) and to those obtained by mean transit time calculation following fitting to a local density random walk model (R(2) = 0.80) in a subset of this cohort. CONCLUSION Combined with a signal truncation algorithm, the inflection point method provides robust, automated determination of PTT from noisy IDCs containing recirculation artifacts. SIGNIFICANCE The inflection point method addresses the need for computational analysis of IDCs obtained from contrast echocardiograms that are not amenable to first-pass model fitting.
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