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EXPERIMENTAL STUDIES

Validation of the accuracy of both right and left ventricular outflow volume determinations and semiautomated calculation of shunt volumes through atrial septal defects by digital color Doppler flow mapping in a chronic animal model

Takahiro Shiota, MD, FACC^*, Michael Jones, MD, Satoshi Aida, BS, Masahide Chikada, MD, Hiroyuki Tsujino, MS, Taher El-Kadi, MD, AFACC and David J. Sahn, MD, FACC

^* Cleveland Clinic Foundation, Cleveland, Ohio, USA
Laboratory of Animal Medicine and Surgery, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
Toshiba Corporation, Tokyo, Japan
Oregon Health Sciences University, Portland, Oregon, USA

Manuscript received March 18, 1998; revised manuscript received March 6, 1999, accepted April 14, 1999.

Reprint requests and correspondence: Dr. Michael Jones, Laboratory of Animal Medicine and Surgery, National Heart, Lung and Blood Institute, 9000 Rockville Pike, Building 14E, Room 1074A, Bethesda, Maryland 20892

OBJECTIVES

The aim of the present study was to quantitate shunt flow volumes through atrial septal defects (ASDs) in a chronic animal model with surgically created ASDs using a new semiautomated color Doppler flow calculation method (ACM).

BACKGROUND

Because pulsed Doppler is cumbersome and often inappropriate for color flow computation, new methods such as ACM are of interest.

METHODS

In this study, 13 to 25 weeks after ASDs were surgically created in eight sheep, a total of 24 hemodynamic states were studied at a separate open chest experimental session. Electromagnetic (EM) flow probes and meters were used to provide reference flow volumes as the pulmonary and aortic flow volumes (Q_p and Q_s) and shunt flow volumes (Q_p minus Q_s). Epicardial echocardiographic studies were performed to image the left and right ventricular outflow tract (LVOT and RVOT) forward flow signals. The ACM method digitally integrated spatial and temporal color flow velocity data to provide stroke volumes.

RESULTS

Left ventricular outflow tract and RVOT flow volumes obtained by the ACM method agreed well with those obtained by the EM method (r = 0.96, mean difference = 0.78 ± 1.7 ml for LVOT and r = 0.97, mean difference = –0.35 ± 3.6 ml for RVOT). As a result, shunt flow volumes and Q_p/Q_s by the ACM method agreed well with those obtained by the EM method (r = 0.96, mean difference = –1.1 ± 3.6 ml/beat for shunt volumes and r = 0.95, mean difference = –0.11 ± 0.22 for Q_p/Q_s).

CONCLUSIONS

This animal study, using strictly quantified shunt flow volumes, demonstrated that the ACM method can provide Q_p/Q_s and shunt measurements semiautomatically and noninvasively.

Abbreviations and Acronyms   ACM = automated computation method   ASD = atrial septal defect   LVOT = left ventricular outflow tract   Qp/Qs = pulmonary/systemic flow   RVOT = right ventricular outflow tract

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