Key result
Continuous wave Doppler of MR estimates LAP with ~0.89 correlation to gold standard catheterization.
Why the study?
The study sought to investigate the accuracy of estimating left atrial pressure using the continuous wave Doppler spectrum of mitral regurgitation.
Does continuous wave Doppler spectrum of mitral regurgitation accurately estimate left atrial pressure compared to catheter measurement in dog models of left atrial hypertension?
Does continuous wave Doppler spectrum of mitral regurgitation accurately estimate left atrial pressure compared to catheter measurement in dog models of left atrial hypertension?
Ultrasound evaluation using continuous wave Doppler spectrum of mitral regurgitation correlates well with invasive catheter measurements for estimating left atrial pressure in a canine model.
Background: This study sought to investigate the accuracy of estimating left atrial pressure (LAP) using the continuous wave Doppler spectrum of mitral regurgitation. Methods: Dog models of left atrial hypertension with mitral regurgitation were established with disposable biopsy forceps and the injection of melamine formaldehyde resin microsphere suspension. A total of 40 models of left atrial hypertension with different hemodynamic statuses were established by injecting either esmolol or dobutamine in which the spectrums of mitral regurgitation were clear and the regurgitation velocity exceeded 3.5 m/s. The continuous wave Doppler spectrums of mitral regurgitation were recorded and analyzed to estimate left atrial pressure (LAPECHO). The mean left atrial pressure (LAPC-MEAN), the isovolumic diastolic left atrial pressure (LAPC-IVRT), the maximum left atrial pressure (LAPC-MAX), and the minimum left atrial pressure (LAPC-MIN) were also measured using the catheter method in the same cardiac cycle. Results: The LAPECHO (mean ± standard deviation; 11.77±4.36 mmHg) was correlated with the LAPC-MEAN (11.51±4.77 mmHg; r=0.887, P=0.000), but the difference was not statistically significant (P=0.459). The LAPECHO was correlated with the LAPC-IVRT (12.16±4.72 mmHg; r=0.883, P=0.000), but the difference was not statistically significant (P=0.271). There was a correlation between the LAPC- MEAN and the LAPC-IVRT (r=0.987, P=0.000), and the difference was statistically significant (P=0.000). Conclusions: This study suggests that the ultrasound evaluation of LAP correlates well with LAP measured using the gold standard catheter method, and is a simple, convenient, non-invasive method to quantitatively estimate LAP. This method is promising, but further large-scale animal experiments and clinical studies need to be conducted.
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Zheng et al. (2022) studied Left atrial hypertension with mitral regurgitation (n=40). Continuous wave Doppler spectrum technique (LAPECHO) vs. Catheter method (LAPC-MEAN) was evaluated on Correlation between LAPECHO and LAPC-MEAN (r=0.887, p=0.000). Estimating left atrial pressure using the continuous wave Doppler spectrum of mitral regurgitation correlated strongly with the gold standard catheter method (r=0.887, P=0.000).
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