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Fu Y, Taghvafard H, Said MM, Rossman EI, Collins TA, Billiald‐Desquand S, Leishman D, Graaf PH, Hasselt JGC, Snelder N. A novel cardiovascular systems model to quantify drugs effects on the inter‐relationship between contractility and other hemodynamic variables. CPT Pharmacometrics Syst Pharmacol 2022; 11:640-652. [PMID: 35213797 PMCID: PMC9124360 DOI: 10.1002/psp4.12774] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 11/28/2022] Open
Abstract
The use of systems‐based pharmacological modeling approaches to characterize mode‐of‐action and concentration‐effect relationships for drugs on specific hemodynamic variables has been demonstrated. Here, we (i) expand a previously developed hemodynamic system model through integration of cardiac output (CO) with contractility (CTR) using pressure‐volume loop theory, and (ii) evaluate the contribution of CO data for identification of system‐specific parameters, using atenolol as proof‐of‐concept drug. Previously collected experimental data was used to develop the systems model, and included measurements for heart rate (HR), CO, mean arterial pressure (MAP), and CTR after administration of atenolol (0.3–30 mg/kg) from three in vivo telemetry studies in conscious Beagle dogs. The developed cardiovascular (CVS)‐contractility systems model adequately described the effect of atenolol on HR, CO, dP/dtmax, and MAP dynamics and allowed identification of both system‐ and drug‐specific parameters with good precision. Model parameters were structurally identifiable, and the true mode of action can be identified properly. Omission of CO data did not lead to a significant change in parameter estimates compared to a model that included CO data. The newly developed CVS‐contractility systems model characterizes short‐term drug effects on CTR, CO, and other hemodynamic variables in an integrated and quantitative manner. When the baseline value of total peripheral resistance is predefined, CO data was not required to identify drug‐ and system‐specific parameters. Confirmation of the consistency of system‐specific parameters via inclusion of data for additional drugs and species is warranted. Ultimately, the developed model has the potential to be of relevance to support translational CVS safety studies.
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Affiliation(s)
- Yu Fu
- Leiden Academic Centre for Drug Research Leiden University Leiden The Netherlands
| | - Hadi Taghvafard
- Leiden Academic Centre for Drug Research Leiden University Leiden The Netherlands
| | - Medhat M. Said
- Leiden Academic Centre for Drug Research Leiden University Leiden The Netherlands
| | | | - Teresa A. Collins
- Clinical Pharmacology and Quantitative Pharmacology Clinical Pharmacology and Safety Sciences R&D, AstraZeneca Royston UK
| | | | | | - Piet H. Graaf
- Leiden Academic Centre for Drug Research Leiden University Leiden The Netherlands
- Certara QSP Canterbury UK
| | - J. G. Coen Hasselt
- Leiden Academic Centre for Drug Research Leiden University Leiden The Netherlands
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Jeong H, Lee H, Jung J, Kim H, Yu J, Yoon H, Lee Y, Chang J, Chang D. Evaluation of left ventricular function with cardiac magnetic resonance imaging and echocardiography after administration of dobutamine and esmolol in healthy beagle dogs. J Vet Med Sci 2021; 83:581-591. [PMID: 33473057 PMCID: PMC8111355 DOI: 10.1292/jvms.18-0703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Unlike echocardiography, cardiac magnetic resonance imaging (cardiac MRI) results in a
near-exact assessment of cardiac structures and function. However, most veterinary studies
have focused on dogs with normal cardiac function. We hypothesized that there would be
significant differences in cardiac measurements between cardiac MRI and echocardiography
when left ventricular (LV) function was abnormal. This study was undertaken to compare
measurements of LV function produced by cardiac MRI and echocardiography in dogs whose LV
function was altered by pharmacological agents. This study was conducted with six healthy
beagle dogs. We increased left ventricular contractility by administration of dobutamine;
we decreased cardiac contractility with esmolol. Stroke volume measurements were made by
using both cardiac MRI and echocardiography under seven different conditions with general
anesthesia: control, three doses of esmolol (100, 200, and 500 µg/kg/min), and three doses
of dobutamine (10, 20, and 50 µg/kg/min). Experiments involving each condition were
conducted at least 1 week apart. When LV contractility was normal, ejection fraction (EF)
and stroke volume (SV), as measured by echocardiography and cardiac MRI, were not
significantly different. However, when contractility was changed by pharmacological
agents, EF and SV were overestimated by echocardiography, compared to MRI. Evaluation of
cardiac function in patients treated with pharmacological agents should be conducted
carefully because EF and SV measured by echocardiography can be overestimated, compared
with EF and SV obtained by cardiac MRI.
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Affiliation(s)
- Hyeryoung Jeong
- Section of Medical Imaging, Veterinary Medical Center, Chungbuk National University, Cheongju 28644, Korea
| | - Hanbin Lee
- Section of Medical Imaging, Veterinary Medical Center, Chungbuk National University, Cheongju 28644, Korea
| | - Jaihyun Jung
- Section of Medical Imaging, Veterinary Medical Center, Chungbuk National University, Cheongju 28644, Korea
| | - Hyunryung Kim
- Section of Medical Imaging, Veterinary Medical Center, Chungbuk National University, Cheongju 28644, Korea
| | - Jin Yu
- Section of Medical Imaging, Veterinary Medical Center, Chungbuk National University, Cheongju 28644, Korea
| | - Hyounglok Yoon
- Section of Medical Imaging, Veterinary Medical Center, Chungbuk National University, Cheongju 28644, Korea
| | - Youngjae Lee
- Section of Medical Imaging, Veterinary Medical Center, Chungbuk National University, Cheongju 28644, Korea
| | - Jinhwa Chang
- Section of Medical Imaging, Veterinary Medical Center, Chungbuk National University, Cheongju 28644, Korea
| | - Dongwoo Chang
- Section of Medical Imaging, Veterinary Medical Center, Chungbuk National University, Cheongju 28644, Korea
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Dennler M, Toaldo MB, Makara M, Lautenschläger IE, Ribbers G, Wang-Leandro A, Waschk M, Richter H, Glaus TM. Recommendations for standardized plane definition in canine cardiac MRI. Vet Radiol Ultrasound 2020; 61:696-704. [PMID: 32996225 DOI: 10.1111/vru.12911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/05/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022] Open
Abstract
With the growing interest in cardiac magnetic resonance imaging (cMRI), veterinary radiologists will increasingly be asked to use this modality to answer complex cardiological questions. Plane alignment is crucial for reproducible assessment of the heart. Anesthesia time is a limiting factor in cMRI. Aims of this prospective experimental study were to introduce a flow chart for standardized cMRI-examination in dogs, to test it for reproducibility using a cardiac CT simulation and to estimate time requirements needed to complete the examination accurately. Six operators (3 radiologists, 1 cardiologist, 1 imaging-resident, 1 technician) simulated a cMRI examination on CT-scans of 6 healthy Beagle dogs twice within two to four weeks. Assessment included qualitative and quantitative scoring of plane quality and time requirements. The quality of planes was high for the left and moderate for the right side of the heart. The intraclass correlation coefficient (ICC) of linear measurements of structures on the left was good to excellent (ICC-range: 0.789-0.948) but dropped to moderate to poor levels for the right side (ICC-range: 0.429-0.738). The median time required to complete a full examination was 30 (range: 13-103) min in the first and 24 (range: 15-62) min in the second evaluation. It differed significantly between operators and was consistently shorter for the left than for the right side. In conclusion, a new standardized scheme for cMRI can be quickly adopted by radiologists with some expertise in cross sectional imaging. Qualitative and quantitative results were highly reproducible for the left but less for the right side.
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Affiliation(s)
- Matthias Dennler
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Marco Baron Toaldo
- Division of Cardiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Mariano Makara
- Centre for Veterinary Education, University Veterinary Teaching Hospital, University of Sydney, New South Wales, Australia
| | - Ines E Lautenschläger
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Gianna Ribbers
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Adriano Wang-Leandro
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Maja Waschk
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Henning Richter
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Tony M Glaus
- Division of Cardiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Loughran KA, Larouche-Lebel É, Huh TP, Kraus MS, Oyama MA. Reproducibility of geometric and flow-based echocardiographic measurements used for quantification of left ventricular total and forward stroke volume in healthy dogs. J Vet Cardiol 2020; 30:100-112. [PMID: 32745962 DOI: 10.1016/j.jvc.2020.06.004] [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: 03/09/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cardiac structure and function in dogs are commonly assessed using echocardiography. A variety of linear, area, and flow-based measurements can be used to calculate left ventricular (LV) total stroke volume (TSV) and forward stroke volume (FSV), but the reproducibility of many of these measurements has not been fully studied. We hypothesized that survey of echocardiographic variables would identify those with high reproducibility and inform future investigation of different methods to measure LV TSV and FSV. METHODS The reproducibility of 25 geometric and flow-based echocardiographic measurements was prospectively evaluated in 23 healthy dogs by two experienced observers. Reproducibility (i.e., interobserver agreement) was described using intraclass correlation coefficients. The reproducibility of various methods to calculate LV TSV and FSV was explored. RESULTS Reproducibility was generally good to excellent. Variables of LV width, length, and area and aortic and sinotubular junction diameter and velocity time integral were among measures with the highest reproducibility. Measurements of mitral annular diameter and mitral inflow velocity time integral possessed lower reproducibility. Calculation of LV TSV using measurements involved in the cube and bullet formulas demonstrated higher reproducibility than the Simpson's method of disks or mitral inflow methods. Calculation of LV FSV using LV outflow tract and aortic diameters from the right parasternal view generally demonstrated higher reproducibility compared with the left-sided view. CONCLUSIONS The reproducibility of many simple geometric and flow-based echocardiographic measurements is high. Comparison of the reliability of different measurement informs future investigation of echocardiographic methods to determine LV TSV and FSV in dogs.
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Affiliation(s)
- K A Loughran
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St, Philadelphia PA, 19104, USA
| | - É Larouche-Lebel
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St, Philadelphia PA, 19104, USA
| | - T P Huh
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St, Philadelphia PA, 19104, USA
| | - M S Kraus
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St, Philadelphia PA, 19104, USA
| | - M A Oyama
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St, Philadelphia PA, 19104, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia PA, 19104, USA.
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5
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Kim J, Kim S, Lee Y, Yoon H, Eom K. Contrast Echocardiography in two-dimensional left ventricular measurements: comparison with 256-row multi-detector computed tomography as a reference standard in Beagles. J Vet Sci 2020; 20:e45. [PMID: 31565888 PMCID: PMC6769328 DOI: 10.4142/jvs.2019.20.e45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/20/2019] [Accepted: 07/17/2019] [Indexed: 12/30/2022] Open
Abstract
Unenhanced echocardiography (UE), commonly used in veterinary practice, is limited by left ventricular (LV) foreshortening and observer dependency. Contrast echocardiography (CE) was used to compare two-dimensional (2D) LV measurements made using UE and 256-row multi-detector computed tomography (MDCT) as a reference standard. Seven healthy beagle dogs were evaluated in this study. Measurements obtained using CE, including LV wall thickness, internal diameter, and longitudinal and transverse length, were significantly greater than those obtained using UE. Measurements of LV internal dimension in diastole (LVIDd) and systole (LVIDs) were significantly larger with CE compared UE. Regardless of the cardiac cycle, LV longitudinal (LVLd and LVLs) and transverse diameter (LVTDd and LVTDs) measurements were significantly different with CE and approximated values from MDCT. Among automatically calculated parameters, LV end-systolic volume and the relative wall thickness were significantly different between UE and CE. In CE, the correlation coefficients of 4 major parameters (r = 0.87 in LVIDd; 0.91 in LVIDs; 0.87 in LVLd; and 0.81 in LVLs) showed higher values compared to the UE (r = 0.68 in LVIDd, 0.71 in LVIDs, 0.69 in LVLd, and 0.35 in LVLs). Inter-observer agreement was highest for MDCT and higher for CE than UE. In conclusion, CE is more accurate and reproducible than UE in assessing 2D LV measurements and can overcome the limitations of UE including LV foreshortening and high observer dependency.
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Affiliation(s)
- Jaehwan Kim
- Helix Animal Medical Center, Seoul 06546, Korea
| | - Soyoung Kim
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Yeonhea Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Kidong Eom
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea.
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Dennler M, Richter H, Matos JN, Toaldo MB, Campagna IU, Glaus TM, Kircher PR. Comparison of left and right ventricular stroke volume of dogs calculated on the basis of morphology and blood flow determined by use of cardiac magnetic resonance imaging. Am J Vet Res 2017; 78:1163-1170. [DOI: 10.2460/ajvr.78.10.1163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lee Y, Jung J, Park J, Jeong J, Jeon S, Park S, Chang J, Kang JH, Lee C, Chang D. CARDIAC MAGNETIC RESONANCE IMAGING OF PATENT DUCTUS ARTERIOSUS IN THREE DOGS. Vet Radiol Ultrasound 2016; 58:62-75. [DOI: 10.1111/vru.12446] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/13/2016] [Indexed: 01/20/2023] Open
Affiliation(s)
- Youngjae Lee
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Jaihyun Jung
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Junyong Park
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Jiyoon Jeong
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Seokho Jeon
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Sunyoung Park
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Jinhwa Chang
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Ji-Houn Kang
- Laboratory of Veterinary Internal Medicine; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Chulhyun Lee
- Bioimaging Research Team; Korea Basic Science Institute; Cheongju Korea
| | - Dongwoo Chang
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
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Sargent J, Connolly DJ, Watts V, Mõtsküla P, Volk HA, Lamb CR, Luis Fuentes V. Assessment of mitral regurgitation in dogs: comparison of results of echocardiography with magnetic resonance imaging. J Small Anim Pract 2015; 56:641-50. [DOI: 10.1111/jsap.12410] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 07/29/2015] [Accepted: 09/03/2015] [Indexed: 11/28/2022]
Affiliation(s)
- J. Sargent
- The Royal Veterinary College; University of London; Herts AL9 7TA
| | - D. J. Connolly
- The Royal Veterinary College; University of London; Herts AL9 7TA
| | - V. Watts
- The Royal Veterinary College; University of London; Herts AL9 7TA
| | - P. Mõtsküla
- The Royal Veterinary College; University of London; Herts AL9 7TA
| | - H. A. Volk
- The Royal Veterinary College; University of London; Herts AL9 7TA
| | - C. R. Lamb
- The Royal Veterinary College; University of London; Herts AL9 7TA
| | - V. Luis Fuentes
- The Royal Veterinary College; University of London; Herts AL9 7TA
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Drees R, Johnson RA, Stepien RL, Munoz Del Rio A, François CJ. Effects of two different anesthetic protocols on cardiac flow measured by two dimensional phase contrast magnetic resonance imaging. Vet Radiol Ultrasound 2015; 56:168-75. [PMID: 25124271 PMCID: PMC4329287 DOI: 10.1111/vru.12200] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 05/04/2014] [Indexed: 01/01/2023] Open
Abstract
Companion animals are routinely anesthetized or heavily sedated for cardiac MRI studies, however effects of varying anesthetic protocols on cardiac function measurements are incompletely understood. The purpose of this prospective study was to compare effects of two anesthetic protocols (Protocol A: Midazolam, fentanyl; Protocol B: Dexmedetomidine) on quantitative and qualitative blood flow values measured through the aortic, pulmonic, mitral, and tricuspid valves using two-dimensional phase contrast magnetic resonance imaging (2D PC MRI) in healthy dogs. Mean flow per heartbeat values through the pulmonary artery (Qp) and aorta (Qs) were compared to right and left ventricular stroke volumes (RVSV, LVSV) measured using a reference standard of 2D Cine balanced steady-state free precession MRI. Pulmonary to systemic flow ratio (Qp/Qs) was also calculated. Differences in flow and Qp/Qs values generated using 2D PC MRI did not differ between the two anesthetic protocols (P = 1). Mean differences between Qp and RVSV were 3.82 ml/beat (95% limits of agreement: 3.62, -11.26) and 1.9 ml/beat (-7.86, 11.66) for anesthesia protocols A and B, respectively. Mean differences between Qs and LVSV were 1.65 ml/beat (-5.04, 8.34) and 0.03 ml/beat (-4.65, 4.72) for anesthesia protocols A and B, respectively. Mild tricuspid or mitral reflux was seen in 2/10 dogs using 2D PC MRI. No aortic or pulmonic insufficiency was observed. Findings from the current study indicated that these two anesthetic protocols yield similar functional measures of cardiac blood flow using 2D PC MRI in healthy dogs. Future studies in clinically affected patients are needed.
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Affiliation(s)
- Randi Drees
- VMTH DSS, UW-Madison, Madison, WI, 53726, USA
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