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      Admittance‐based pressure–volume loops versus gold standard cardiac magnetic resonance imaging in a porcine model of myocardial infarction

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          Abstract

          A novel admittance‐based pressure–volume system (AS) has recently been developed and introduced. Thus far, the new technique has been validated predominantly in small animals. In large animals it has only been compared to three‐dimensional echocardiography (3DE) where the AS showed to overestimate left ventricular (LV) volumes. To fully determine the accuracy of this device, we compared the AS with gold standard cardiac magnetic resonance imaging (CMRI) in a porcine model of chronic myocardial infarction (MI). Fourteen pigs were subjected to 90 min closed chest balloon occlusion of the left anterior descending artery. After 8 weeks of follow up, pigs were consecutively subjected to LV volume measurements by the AS, CMRI, and 3DE under general anesthesia. The AS overestimated end diastolic volume (EDV; +20.9 ± 30.6 mL, P = 0.024) and end systolic volume (ESV; +17.7 ± 29.4 mL, P = 0.042) but not ejection fraction (EF; +2.46 ± 6.16%, P = NS) compared to CMRI. Good correlations of EDV ( R = 0.626, P = 0.017) and EF ( R = 0.704, P = 0.005) between the AS and CMRI were observed. EF measured by the AS and 3DE also correlated significantly ( R = 0.624, P = 0.030). After subjection of pigs to MI, the AS very moderately overestimates LV volumes and shows accurate measurements for EF compared to CMRI. This makes the AS a useful tool to determine cardiac function and dynamic changes in large animal models of cardiac disease.

          Abstract

          Is the novel admittance‐based pressure–volume loop system reliable for the assessment of left ventricular volumes compared to gold standard cardiac magnetic resonance imaging in a porcine model of myocardial infarction? In the postinfarction remodeled heart, admittance‐based pressure–volume loop measurements accurately measure ejection fraction and very moderately overestimate end diastolic and end systolic volumes compared to gold standard cardiac magnetic resonance imaging, making it a very useful technique for cardiac function assessment in experimental studies.

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          Most cited references12

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          Instantaneous pressure-volume relationships and their ratio in the excised, supported canine left ventricle.

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            Performance of 3-dimensional echocardiography in measuring left ventricular volumes and ejection fraction: a systematic review and meta-analysis.

            The primary aim of this systematic review is to objectively evaluate the test performance characteristics of three-dimensional echocardiography (3DE) in measuring left ventricular (LV) volumes and ejection fraction (EF). Despite its growing use in clinical laboratories, the accuracy of 3DE has not been studied on a large scale. It is unclear if this technology offers an advantage over traditional two-dimensional (2D) methods. We searched for studies that compared LV volumes and EF measured by 3DE and cardiac magnetic resonance (CMR) imaging. A subset of those also compared standard 2D methods with CMR. We used meta-analyses to determine the overall bias and limits of agreement of LV end-diastolic volume (EDV), end-systolic volume (ESV), and EF measured by 3DE and 2D echocardiography (2DE). Twenty-three studies (1,638 echocardiograms) were included. The pooled biases ± 2 SDs for 3DE were -19.1 ± 34.2 ml, -10.1 ± 29.7 ml, and - 0.6 ± 11.8% for EDV, ESV, and EF, respectively. Nine studies also included data from 2DE, where the pooled biases were -48.2 ± 55.9 ml, -27.7 ± 45.7 ml, and 0.1 ± 13.9% for EDV, ESV, and EF, respectively. In this subset, the difference in bias between 3DE and 2D volumes was statistically significant (p = 0.01 for both EDV and ESV). The difference in variance was statistically significant (p < 0.001) for all 3 measurements. Three-dimensional echocardiography underestimates volumes and has wide limits of agreement, but compared with traditional 2D methods in these carefully performed studies, 3DE is more accurate for volumes and more precise in all 3 measurements. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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              Head-to-head comparison of left ventricular function assessment with 64-row computed tomography, biplane left cineventriculography, and both 2- and 3-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging as the reference standard.

              This study was designed to compare the accuracy of 64-row contrast computed tomography (CT), invasive cineventriculography (CVG), 2-dimensional echocardiography (2D Echo), and 3-dimensional echocardiography (3D Echo) for left ventricular (LV) function assessment with magnetic resonance imaging (MRI). Cardiac function is an important determinant of therapy and is a major predictor for long-term survival in patients with coronary artery disease. A number of methods are available for assessment of function, but there are limited data on the comparison between these multiple methods in the same patients. A total of 36 patients prospectively underwent 64-row CT, CVG, 2D Echo, 3D Echo, and MRI (as the reference standard). Global and regional LV wall motion and ejection fraction (EF) were measured. In addition, assessment of interobserver agreement was performed. For the global EF, Bland-Altman analysis showed significantly higher agreement between CT and MRI (p 0.8), whereas agreement was lower for CVG (intraclass correlation coefficient = 0.58). 64-row CT may be more accurate than CVG, 2D Echo, and 3D Echo in comparison with MRI as the reference standard for assessment of global LV function. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Physiol Rep
                Physiol Rep
                physreports
                phy2
                Physiological Reports
                Wiley Periodicals, Inc.
                2051-817X
                1 April 2014
                23 April 2014
                : 2
                : 4
                : e00287
                Affiliations
                [1 ]Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands
                [2 ]Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
                [3 ]Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands
                Author notes
                CorrespondenceImo E. Hoefer, Laboratory of Experimental Cardiology (room G02.523), University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands.Tel: +31‐88‐755‐7155Fax: +31‐30‐252‐2693E‐mail: i.hoefer@ 123456umcutrecht.nl
                Article
                phy2287
                10.14814/phy2.287
                4001878
                24771693
                7cec57cc-6f50-456c-877b-56fdc0f4f1a3
                © 2014 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 March 2014
                : 18 March 2014
                Categories
                Original Research

                admittance,myocardial infarction,pv loops
                admittance, myocardial infarction, pv loops

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