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Jafari-Giv Z, Vajhi A, Farzad-Mohajeri S, Hassankhani M, Alian Samakkhah S, Hemmati A, Mohammadzade-Akbari A, Noroozzadegan M. Positive correlation between echocardiographic tricuspid E peak velocity and central venous pressure in dogs: A preliminary study. Vet Radiol Ultrasound 2024; 65:294-302. [PMID: 38513141 DOI: 10.1111/vru.13357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/29/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024] Open
Abstract
In the absence of vascular obstruction, central venous pressure (CVP) is a hydrostatic pressure in the cranial and caudal vena cava, providing valuable information about cardiac function and intravascular volume status. It is also a component in evaluating volume resuscitation in patients with septic shock and monitoring patients with right heart disease, pericardial disease, or volume depletion. Central venous pressure is calculated in dogs by invasive central venous catheterization, which is considered high-risk and impractical in critically ill patients. This study aimed to investigate the feasibility of using echocardiographic tricuspid E/E' as a noninvasive method to estimate CVP in anesthetized healthy dogs under controlled hypovolemic conditions. Ten male mixed-breed dogs were included in the study after a thorough health assessment. For hypovolemia induction, blood withdrawal was performed, and echocardiographic factors of the tricuspid valve, including peak E and E' velocities, were measured during CVP reduction. Repeated measures analysis of variance and Bonferroni post hoc tests were employed to compare the average difference between measured echocardiographic indices and CVP values derived from catheterization and intermittent measurement methods. Spearman's ρ correlation coefficient was used to evaluate the correlation between echocardiographic indices and CVP. E peak velocity had a significant negative correlation with venous blood pressure phases (r = -0.44, P = .001), indicating a decrease in peak E velocity with progressive CVP reduction. However, tricuspid valve E' peak velocity and E/E' did not correlate with CVP, suggesting that these parameters are not reliable for CVP estimation in dogs.
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Affiliation(s)
- Zahra Jafari-Giv
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Alireza Vajhi
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Saeed Farzad-Mohajeri
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
- Department of Regenerative Medicine, Institute of Biomedical Research, University of Tehran, Tehran, Iran
| | - Mahdi Hassankhani
- Department of Internal Medicine, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Shohreh Alian Samakkhah
- Department of Food Hygiene, Faculty of Veterinary Medicine, Amol University of Special Modern Technologies (AUSMT), Amol, Iran
| | - Amin Hemmati
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
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Giustiniano E, Nisi F, Piccioni F, Gambino F, Aceto R, Lungu R, Carrara A, Neganov M, Cecconi M. Right Ventricle Response to Major Lung Resection (the RIVER Study). J Cardiovasc Echogr 2023; 33:76-82. [PMID: 37772049 PMCID: PMC10529292 DOI: 10.4103/jcecho.jcecho_17_23] [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: 03/17/2023] [Revised: 04/13/2023] [Accepted: 05/21/2023] [Indexed: 09/30/2023] Open
Abstract
Backgrounds Major lung resection is associated with high postoperative morbidity and mortality, especially due to cardiorespiratory complications. Right ventricle (RV) ejection, pulmonary artery (PA) pressure, and tone are tightly coupled. Since the RV is exquisitely sensitive to changes in afterload, an acute increase in RV outflow resistance (i.e., acute pulmonary embolism [PE]) will cause acute RV dilatation and, a reduction of left ventricle compliance too, rapidly spiraling to acute cardiogenic shock and death. We investigated the changing in RV performance after major lung resection. Materials and Methods We carried out transthoracic echocardiography (TTE) aiming at searching for the incidence of early RV systolic dysfunction (defined as tricuspid annulus plane systolic excursion [TAPSE] <17 cm, S'-tissue Doppler imaging <10 cm/s) and estimate the RV-PA coupling by the TAPSE/pulmonary artery pressures (PAPs) ratio after major lung resection. The TTE has been performed before and immediately after surgery. Results After the end of the operation the echocardiographic parameters of the RV function worsened. TAPSE decreased from 24 (21 ÷ 28) to 18 (16 ÷ 22) mm (P = 0.015) and PAPs increased from 26 (25 ÷ 30) to 30 (25 ÷ 39) mmHg (P = 0.013). TAPSE/PAPs ratio decreased from 0.85 (0.80 ÷ 0.90) to 0.64 (0.54 ÷ 0.79) mm/mmHg (P = 0.002). Conclusions In line with previous reports, after major lung resection the increase in afterload reduces the RV function, but the impairment remains clinically not relevant. The different clinical picture of an acute cor pulmonale due to PE implies that the pathogenesis of cardiac failure involves more pathways than the mere mechanic occlusion of the blood flow.
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Affiliation(s)
- Enrico Giustiniano
- Department of Anesthesia and Intensive Care, IRCCS, Humanitas Research Hospital, Milan, Italy
| | - Fulvio Nisi
- Department of Anesthesia and Intensive Care, IRCCS, Humanitas Research Hospital, Milan, Italy
| | - Federico Piccioni
- Department of Anesthesia and Intensive Care, IRCCS, Humanitas Research Hospital, Milan, Italy
| | - Francesco Gambino
- Department of Anesthesia and Intensive Care, IRCCS, Humanitas Research Hospital, Milan, Italy
| | - Romina Aceto
- Department of Anesthesia and Intensive Care, IRCCS, Humanitas Research Hospital, Milan, Italy
| | - Ramona Lungu
- Department of Anesthesia and Intensive Care, IRCCS, Humanitas Research Hospital, Milan, Italy
| | - Alfonso Carrara
- Department of Anesthesia and Intensive Care, IRCCS, Humanitas Research Hospital, Milan, Italy
| | - Maxim Neganov
- Department of Anesthesia and Intensive Care, IRCCS, Humanitas Research Hospital, Milan, Italy
| | - Maurizio Cecconi
- Department of Anesthesia and Intensive Care, IRCCS, Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Lobo L, Esteves-Guimarães J, Oliveira P, Salazar L, Pereira A, Fontes-Sousa AP. Maternal Left Ventricular Diastolic and Systolic Function during Normal Pregnancy in Saint Bernard Dogs. Vet Sci 2021; 8:vetsci8120306. [PMID: 34941833 PMCID: PMC8705166 DOI: 10.3390/vetsci8120306] [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] [Received: 11/07/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to evaluate maternal left ventricular (LV) systo-diastolic function using conventional and TDI echocardiography and included 10 healthy Saint-Bernard pregnant bitches. M-mode, peak transmitral flow velocities during early diastole (E) and atrial contraction (A), aortic and pulmonic flow, myocardial performance index (MPI), TDI studies (peak myocardial velocities during early diastole (E’), atrial contraction (A’) and peak systole (S’)), and blood pressure were measured at 21 to 28 (T1), 40 (T2) and 60 (T3) days of gestation and four to eight weeks postpartum (T4). Cardiac output and heart rate were 20% and 9% higher at T3, respectively, compared to T4 (p < 0.01). Lateral S’ was 36% higher at T3 than at T1 (p < 0.05). Changes in diastolic function were demonstrated by 10% lower E wave and 15% A wave at T1, compared to T4 (p < 0.05). E’ and A’ were 23% and 42% higher at T3 compared to T4 (p < 0.01). Both lateral E/E’ and E’/A’ were 6% and 19% lower at T3 compared to T1 (p < 0.01 and p < 0.05, respectively). At T3, MPI was 51% and 34% lower when compared to T1 or T2 (p < 0.05). The echocardiographic evaluation of maternal cardiac function is important, as structural, and functional changes occur throughout pregnancy.
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Affiliation(s)
- Luís Lobo
- Hospital Veterinário do Porto, 4250-475 Porto, Portugal; (L.L.); (L.S.)
- Faculdade de Medicina Veterinária, Universidade Lusófona de Humanidades e Tecnologias, Campo Grande, 376, 1749-024 Lisboa, Portugal
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto (ICETA), Rua D. Manuel II, Apartado 55142, 4051-401 Porto, Portugal
| | | | - Pedro Oliveira
- Davies Veterinary Specialists, Manor Farm Business Park, Hitchin SG5 3HR, UK;
| | - Luís Salazar
- Hospital Veterinário do Porto, 4250-475 Porto, Portugal; (L.L.); (L.S.)
| | - André Pereira
- Centro Hospitalar Veterinário, 4100-320 Porto, Portugal;
| | - Ana Patrícia Fontes-Sousa
- Centro de Investigação Farmacológica e Inovação Medicamentosa (MedInUP), Departamento de Imuno-Fisiologia e Farmacologia, ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
- Correspondence: ; Tel.: +351-22-0428-227
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Morita T, Nakamura K, Osuga T, Yokoyama N, Morishita K, Sasaki N, Ohta H, Takiguchi M. Effect of acute volume overload on echocardiographic indices of right ventricular function and dyssynchrony assessed by use of speckle tracking echocardiography in healthy dogs. Am J Vet Res 2019; 80:51-60. [DOI: 10.2460/ajvr.80.1.51] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Visser LC, Scansen BA, Schober KE, Bonagura JD. Echocardiographic assessment of right ventricular systolic function in conscious healthy dogs: Repeatability and reference intervals. J Vet Cardiol 2015; 17:83-96. [DOI: 10.1016/j.jvc.2014.10.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/29/2014] [Accepted: 10/21/2014] [Indexed: 01/01/2023]
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Uemura K, Inagaki M, Zheng C, Li M, Kawada T, Sugimachi M. A novel technique to predict pulmonary capillary wedge pressure utilizing central venous pressure and tissue Doppler tricuspid/mitral annular velocities. Heart Vessels 2014; 30:516-26. [PMID: 24879503 DOI: 10.1007/s00380-014-0525-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/09/2014] [Indexed: 11/28/2022]
Abstract
Assessing left ventricular (LV) filling pressure (pulmonary capillary wedge pressure, PCWP) is an important aspect in the care of patients with heart failure (HF). Physicians rely on right ventricular (RV) filling pressures such as central venous pressure (CVP) to predict PCWP, assuming concordance between CVP and PCWP. However, the use of this method is limited because discordance between CVP and PCWP is observed. We hypothesized that PCWP can be reliably predicted by CVP corrected by the relationship between RV and LV function, provided by the ratio of tissue Doppler peak systolic velocity of tricuspid annulus (S(T)) to that of mitral annulus (S(M)) (corrected CVP:CVP·S(T)/S(M)). In 16 anesthetized closed-chest dogs, S T and S M were measured by transthoracic tissue Doppler echocardiography. PCWP was varied over a wide range (1.8-40.0 mmHg) under normal condition and various types of acute and chronic HF. A significantly stronger linear correlation was observed between CVP·S(T)/S(M) and PCWP (R2 = 0.78) than between CVP and PCWP (R2 = 0.22) (P < 0.01). Receiver-operating characteristic (ROC) analysis indicated that CVP·S(T)/S(M) >10.5 mmHg predicted PCWP >18 mmHg with 85% sensitivity and 88% specificity. Area under ROC curve for CVP·S T/S M to predict PCWP >18 mmHg was 0.93, which was significantly larger than that for CVP (0.66) (P < 0.01). Peripheral venous pressure (PVP) corrected by S T/S M (PVP·S(T)/S(M) also predicted PCWP reasonably well, suggesting that PVP·S(T)/S (M) may be a minimally invasive alternative to CVP·S(T)/S(M) In conclusion, our technique is potentially useful for the reliable prediction of PCWP in HF patients.
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Affiliation(s)
- Kazunori Uemura
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, 565-8565, Japan,
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