Echocardiographic assessment of right ventricular function in experimental pulmonary hypertension

Zhu, Zhongkai; Godana, Dureti; Li, Ailing; Rodriguez, Bianca; Gu, Chenxin; Tang, Haiyang; Minshall, Richard D.; Huang, Wei; Chen, Jiwang

doi:10.1177/2045894019841987

Cited by 43 publications

(32 citation statements)

References 31 publications

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“…Other investigators have assessed RVWTd and found association with RV weight and pressure, but the range of RVWT has varied widely between these reports. 20–24 Our measurements are consistent with those of Urboniene et al., who used the MCT model and the same strain of rats as in our study. 22 Although the ICC measurements for RVWT reflect strong inter-rater reliability, it is not as strong as the ICC for PAAT and PAAT/ET in the derivation phase.…”

Section: Discussionsupporting

confidence: 92%

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Echocardiographic markers of pulmonary hemodynamics and right ventricular hypertrophy in rat models of pulmonary hypertension

et al. 2020

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Echocardiography is the gold standard non-invasive technique to diagnose pulmonary hypertension. It is also an important modality used to monitor disease progression and response to treatment in patients with pulmonary hypertension. Surprisingly, only few studies have been conducted to validate and standardize echocardiographic parameters in experimental animal models of pulmonary hypertension. We sought to define cut-off values for both invasive and non-invasive measures of pulmonary hemodynamics and right ventricular hypertrophy that would reliably diagnose pulmonary hypertension in three different rat models. The study was designed in two phases: (1) a derivation phase to establish the cut-off values for invasive measures of right ventricular systolic pressure, Fulton's index (right ventricular weight/left ventricle + septum weight), right ventricular to body weight ratio, and non-invasive echocardiographic measures of pulmonary arterial acceleration time, pulmonary arterial acceleration time to ejection time ratio and right ventricular wall thickness in diastole in the hypoxic and monocrotaline rat models of pulmonary hypertension and (2) a validation phase to test the performance of the cut-off values in predicting pulmonary hypertension in an independent cohort of rats with Sugen/hypoxia-induced pulmonary hypertension. Our study demonstrates that right ventricular systolic pressure ≥35.5 mmHg and Fulton's Index ≥0.34 are highly sensitive (>94%) and specific (>91%) cut-offs to distinguish animals with pulmonary hypertension from controls. When pulmonary arterial acceleration time/ejection time and right ventricular wall thickness in diastole were both measured, a result of either pulmonary arterial acceleration time/ejection time ≤0.25 or right ventricular wall thickness in diastole ≥1.03 mm detected right ventricular systolic pressure ≥35.5 mmHg or Fulton's Index ≥0.34 with a sensitivity of 88% and specificity of 100%. With properly validated non-invasive echocardiography measures of right ventricular performance in rats that accurately predict invasive measures of pulmonary hemodynamics, future studies can now utilize these markers to test the efficacy of different treatments with preclinical therapeutic modeling.

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Section: Discussionsupporting

confidence: 92%

“…However, none of the previous studies have validated these echocardiography measures against invasive cut-off values that detect PH in rat models. 20–24…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic markers of pulmonary hemodynamics and right ventricular hypertrophy in rat models of pulmonary hypertension

et al. 2020

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“…These indices were unchanged due to profound right ventricular dysfunction manifested by decreased TAPSE. Attenuated PAAT:ET in RV failure with decreased TAPSE has been reported in models of pulmonary hypertension 28 . As such, we are unable to comment specifically upon pulmonary vascular hemodynamics in this study.…”

Section: Discussionmentioning

confidence: 71%

“…26 PAAT:ET in RV failure with decreased TAPSE has been reported in models of pulmonary hypertension. 28 As such, we are unable to comment specifically upon pulmonary vascular hemodynamics in this F I G U R E 5 Ultrasound lung injury score. Ultrasound images captured at baseline, 1 hour posttreatment and at end of study; scores are represented as mean ± SE for each group.…”

Section: Discussionmentioning

confidence: 91%

Lung ultrasound predicts histological lung injury in a neonatal model of acute respiratory distress syndrome

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Graham

et al. 2020

Pediatric Pulmonology

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Rationale: Point-of-care ultrasound (POCUS) is used to evaluate pulmonary edema in adults with acute respiratory distress syndrome (ARDS). Its use has not been validated in neonatal models. Objectives: We compared an in vivo lung ultrasound score against clinical and histological markers of acute lung injury, in a neonatal animal model, hypothesizing that POCUS would sensitively diagnose early acute lung injury in neonates and discern its severity. Methods: Fifteen anesthetized, ventilated 3-day-old neonatal piglets were divided into controls, moderate lung injury, or severe lung injury by graded treatment with oleic acid. Degree of lung injury was quantified at baseline, immediately after oleic acid administration, and 1 hour after the evolution of acute lung injury, by blood gases, ventilation parameters and calculated oxygenation deficit; hemodynamic indices by echocardiography, and lung ultrasound obtained in an 8-region grid of anterior and posterior zones, semi-quantitatively analyzed by a blinded observer. Lungs were inflation-fixed postmortem at last mean airway pressure, for histological assessment. Results: Acute lung injury manifested in oleic acid-treated groups as dosedependent capillary leak causing intravascular depletion and cardiac failure, hypoxemia with increasing intrapulmonary shunt fraction, decreased lung compliance, and resistance. Ultrasound scores of anterior regions distinguished moderate from severe injury; scores in posterior regions reached maximum values immediately after lung injury. POCUS score correlated with calculated intrapulmonary shunt fraction (R 2 = .65) and with histological injury score (R 2 = .61), P < .01. Conclusion: We conclude that POCUS may be valuable in neonates for early quantification of acute lung injury or ARDS; and that nondependent ultrasound regions clearly distinguish severity of pulmonary edema.

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“…Hematoxylin and eosin (H&E) staining was performed on the hearts sections. 20 – 22 The images were scanned using the Pannoramic SCAN system (3DHISTECH, Budapest, Hungary) and analyzed with the Case Viewer software program.…”

Section: Methodsmentioning

confidence: 99%

Echocardiographic assessment of right ventricular function in experimental pulmonary hypertension

Cited by 43 publications

References 31 publications

Echocardiographic markers of pulmonary hemodynamics and right ventricular hypertrophy in rat models of pulmonary hypertension

Echocardiographic markers of pulmonary hemodynamics and right ventricular hypertrophy in rat models of pulmonary hypertension

Lung ultrasound predicts histological lung injury in a neonatal model of acute respiratory distress syndrome

DDCI‐01, a novel long acting phospdiesterase‐5 inhibitor, attenuated monocrotaline‐induced pulmonary hypertension in rats

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