Key result
Subharmonic-aided pressure estimation with Sonazoid microbubbles estimated right ventricular systolic pressure with a mean error of 1.6 mm Hg ± 1.5 (P = .85) compared to fluid-filled catheters.
Why the study?
To investigate whether right ventricular systolic and left ventricular diastolic pressures can be obtained noninvasively using the subharmonic-aided pressure estimation (SHAPE) technique with Sonazoid microbubbles.
Does the subharmonic-aided pressure estimation (SHAPE) technique with Sonazoid microbubbles accurately estimate right ventricular systolic and left ventricular diastolic pressures compared to invasive catheterization?
Does the subharmonic-aided pressure estimation (SHAPE) technique with Sonazoid microbubbles accurately estimate right ventricular systolic and left ventricular diastolic pressures compared to invasive catheterization?
The SHAPE technique using Sonazoid microbubbles demonstrates potential as a noninvasive method for estimating clinically relevant right ventricular systolic and left ventricular diastolic pressures.
SHAPE may support noninvasive RV systolic estimation but shows larger LV diastolic errors; leaves open clinical utility pending prospective validation.
Purpose To investigate if the right ventricular (RV) systolic and left ventricular (LV) diastolic pressures can be obtained noninvasively using the subharmonic-aided pressure estimation (SHAPE) technique with Sonazoid microbubbles. Materials and Methods Individuals scheduled for a left and/or right heart catheterization were prospectively enrolled in this institutional review board–approved clinical trial from 2017 to 2020. A standard-of-care catheterization procedure was performed by advancing fluid-filled pressure catheters into the LV and aorta (n = 25) or RV (n = 22), and solid-state high-fidelity pressure catheters into the LV and aorta in a subset of participants (n = 18). Study participants received an infusion of Sonazoid microbubbles (GE HealthCare), and SHAPE data were acquired using a validated interface developed on a SonixTablet (BK Medical) US scanner, synchronously with the pressure catheter data. A conversion factor, derived using cuff-based pressure measurements with a SphygmoCor XCEL PWA (ATCOR) and subharmonic signal from the aorta, was used to convert the subharmonic signal into pressure values. Errors between the pressure measurements obtained using the SHAPE technique and pressure catheter were compared. Results The mean errors in pressure measurements obtained with the SHAPE technique relative to those of the fluid-filled pressure catheter were 1.6 mm Hg ± 1.5 [SD] (P = .85), 8.4 mm Hg ± 6.2 (P = .04), and 7.4 mm Hg ± 5.7 (P = .09) for RV systolic, LV minimum diastolic, and LV end-diastolic pressures, respectively. Relative to the measurements with the solid-state high-fidelity pressure catheter, the mean errors in LV minimum diastolic and LV end-diastolic pressures were 7.2 mm Hg ± 4.5 and 6.8 mm Hg ± 3.3 (P ≥ .44), respectively. Conclusion These results indicate that SHAPE with Sonazoid may have the potential to provide clinically relevant RV systolic and LV diastolic pressures. Keywords: Ultrasound-Contrast, Cardiac, Aorta, Left Ventricle, Right Ventricle ClinicalTrials.gov registration no.: NCT03245255 © RSNA, 2024
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Esposito et al. (2024) studied Scheduled for left and/or right heart catheterization. Subharmonic-aided pressure estimation (SHAPE) with Sonazoid microbubbles vs. Invasive pressure catheters was evaluated on Mean error in pressure measurements relative to fluid-filled pressure catheter (Mean error 1.6 mm Hg, p=.85). Subharmonic-aided pressure estimation with Sonazoid microbubbles estimated right ventricular systolic pressure with a mean error of 1.6 mm Hg ± 1.5 (P = .85) compared to fluid-filled catheters.
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