Name: closed chest biventricular pressure-volume loop recordings with admittance catheters in a porcine model
Uploaded: 2021-05-18T15:00:00
Description: Watch this Scientific Journal Video about Closed Chest Biventricular Pressure-Volume Loop Recordings with Admittance Catheters in a Porcine Model at JoVE.com

这项工作得到了挪度急性医学基金会（3374），Holger和Ruth Hesse的纪念基金会，Søster和Verner Lippert基金会，诺和诺德基金会（NNF16OC0023244，NFF17CO0024868）和阿尔弗雷德·本松基金会的支持。

该协议是根据丹麦和机构关于动物福利和伦理的指导方针制定和使用的。丹麦动物研究监察局批准了该研究（许可证号：2016-15-0201-00840）。使用了约60公斤的丹麦雌性屠宰猪（Landrace，Yorkshire和Duroc的杂交品种）。
1. 麻醉和通气
<ol><li>用Zoletil混合物1 mL / kg（ 见材料表）作为肌内注射预先麻醉清醒的猪，以减少动物在运输过程中的压力，疼痛和焦虑。</li>
	<li>将动...

<ol>
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An official american thoracic society research statement.</a> American Journal of Respiratory and Critical Care Medicine. 198 (4), e15-e43 (2018).</li><li>Morimont, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effective+arterial+elastance+as+an+index+of+pulmonary+vascular+load.">Effective arterial elastance as an index of pulmonary vascular load.</a> American Journal of Physiology - Heart and Circulatory Physiology. 294 (6), 2736-2742 (2008).</li><li>Kutty, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validation+of+admittance+computed+left+ventricular+volumes+against+real-time+three-dimensional+echocardiography+in+the+porcine+heart.">Validation of admittance computed left ventricular volumes against real-time three-dimensional echocardiography in the porcine heart.</a> Experimental Physiology. 98 (6), 1092-1101 (2013).</li><li>Bove, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acute+and+chronic+effects+of+dysfunction+of+right+ventricular+outflow+tract+components+on+right+ventricular+performance+in+a+porcine+model:+Implications+for+primary+repair+of+tetralogy+of+fallot.">Acute and chronic effects of dysfunction of right ventricular outflow tract components on right ventricular performance in a porcine model: Implications for primary repair of tetralogy of fallot.</a> Journal of the American College of Cardiology. 60 (1), 64-71 (2012).</li><li>Townsend, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measuring+pressure+volume+loops+in+the+mouse.">Measuring pressure volume loops in the mouse.</a> Journal of Visualized Experiments. 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F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Myocardial+systolic+function+increases+during+positive+pressure+lung+inflation.">Myocardial systolic function increases during positive pressure lung inflation.</a> Anesthesia and Analgesia. 101 (5), 1269-1274 (2005).</li><li>Gorcsan, J., Strum, D. P., Mandarino, W. A., Gulati, V. K., Pinsky, M. 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R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=RV+filling+modulates+LV+function+by+direct+ventricular+interaction+during+mechanical+ventilation.">RV filling modulates LV function by direct ventricular interaction during mechanical ventilation.</a> American Journal of Physiology-Heart and Circulatory Physiology. 289 (2), 549-557 (2005).</li><li>Larson, E. R., Feldman, M. D., Valvano, J. W., Pearce, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+the+spatial+sensitivity+of+conductance/admittance+catheter+ventricular+volume+estimation.">Analysis of the spatial sensitivity of conductance/admittance catheter ventricular volume estimation.</a> IEEE Transactions on Biomedical Engineering. 60 (8), 2316-2324 (2013).</li><li>Hout, G. P. 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本文介绍了一种可重复的微创闭合胸入路，用于双心室压力-体积环记录。
将PV导管从RA推进到RV是该协议中最关键的步骤。RV的复杂组成和导管的刚度使插入易于膨胀和几何上具有挑战性的RV变得复杂。这种困难可以解释为什么通常首选开胸器械。在试点研究期间，尝试并放弃了许多通路和技术，包括右颈外静脉通路，胸骨上通路进入上腔静脉和下腔静脉。根据这些试点研究，...

压力-容积 （PV） 回路包含大量血流动力学信息，包括收缩末期和舒张末期压力和血容量、射血分数、卒中量和卒中功1。此外，瞬态预载荷降低创建了一系列环路，从中可以导出与负载无关的变量2，3。这种与负荷无关的心室功能评估使PV环路记录成为血流动力学评估中最先进的。PV环路记录可以在人类身上进行，但主要用于并推荐用于临床前研究4，5，6。
压力-容积环路可从右心室 （RV） 和左心室 （LV） 获得。大多数研究假设都集中在单个心室上，导致仅记录单心室PV环7，8，9，10。然而，左右心室由于在紧绷心包内有连续和平行连接而导致收缩期和舒张期相互依赖性11。一个心室的输出量或大小的变化将影响另一个心室的大小、负荷条件或灌注。因此，双心室PV环记录可以更全面地评估心脏总表现。药物干预也可能对两个心室及其负荷状况产生不同的影响，进一步强调了双心室评估的重要性。
PV 导管可通过多种途径进入任一心室，包括从心脏顶端或通过 RV 流出道进入的开胸入路7、10、12、13、14。然而，胸部的开口会影响生理状况，并可能引入偏倚。
根据我们先前研究的经验15，16，17，18，我们的目标是在急性房车衰竭的大型动物模型中展示我们的闭胸双心室PV环记录方法，对心肺生理学的影响最小（图1）。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>12L-RS</td>
			<td>GE Healthcare Japan</td>
			<td>5141337</td>
			<td>Ultrasound probe</td>
		</tr>
		<tr>
			<td>Adhesive Aperature Drape (OneMed)</td>
			<td>evercare</td>
			<td>1515-01</td>
			<td>75 x 90 cm (hole: 6 x 8 cm)</td>
		</tr>
		<tr>
			<td>Alaris GP Guardrails plus</td>
			<td>CareFusion</td>
			<td>9002TIG01-G</td>
			<td>Infusion pump</td>
		</tr>
		<tr>
			<td>Alaris Infusion set</td>
			<td>BD Plastipak</td>
			<td>60593</td>
			<td></td>
		</tr>
		<tr>
			<td>Alkoholswap</td>
			<td>MEDIQ Danmark</td>
			<td>3340012</td>
			<td>82% ethanol, 0,5% chlorhexidin, skin disinfection</td>
		</tr>
		<tr>
			<td>Amplatz Support Wire Guide Extra-Stiff</td>
			<td>Cook Medical</td>
			<td>THSF-25-260-AES</td>
			<td>diameter: 0.025 inches, length: 260 cm</td>
		</tr>
		<tr>
			<td>BD Connecta</td>
			<td>BD</td>
			<td>394601</td>
			<td>Luer-Lock</td>
		</tr>
		<tr>
			<td>BD Emerald</td>
			<td>BD</td>
			<td>307736</td>
			<td>10 mL syringe</td>
		</tr>
		<tr>
			<td>BD Luer-Lock</td>
			<td>BD Plastipak</td>
			<td>300865</td>
			<td>BD = Becton Dickinson, 50 mL syringe</td>
		</tr>
		<tr>
			<td>BD Platipak</td>
			<td>BD</td>
			<td>300613</td>
			<td>20 mL syringe</td>
		</tr>
		<tr>
			<td>BD Venflon Pro</td>
			<td>Becton Dickinson Infusion Therapy</td>
			<td>393204</td>
			<td>20G</td>
		</tr>
		<tr>
			<td>BD Venflon Pro</td>
			<td>Becton Dickinson Infusion Therapy</td>
			<td>393208</td>
			<td>17G</td>
		</tr>
		<tr>
			<td>Butomidor Vet</td>
			<td>Richter Pharma AG</td>
			<td>531943</td>
			<td>10 mg/mL</td>
		</tr>
		<tr>
			<td>Check-Flo Performer Introducer</td>
			<td>Cook Medical</td>
			<td>RCFW-16.0P-38-30-RB</td>
			<td>16 F sheath, 30 cm long</td>
		</tr>
		<tr>
			<td>Cios Connect S/N 20015</td>
			<td>Siemens Healthineers</td>
			<td></td>
			<td>C-arm</td>
		</tr>
		<tr>
			<td>D-LCC12A-01</td>
			<td>GE Healthcare Finland</td>
			<td></td>
			<td>Pressure measurement monitor</td>
		</tr>
		<tr>
			<td>Durapore</td>
			<td>3M</td>
			<td>-</td>
			<td>Adhesive tape</td>
		</tr>
		<tr>
			<td>E-PRESTIN-00</td>
			<td>GE Healthcare Finland</td>
			<td>6152932</td>
			<td>Respirator tubes</td>
		</tr>
		<tr>
			<td>Exagon vet</td>
			<td>Richter Pharma AG</td>
			<td>427931</td>
			<td>400 mg/mL</td>
		</tr>
		<tr>
			<td>Fast-Cath Hemostasis Introducer 12F</td>
			<td>St. Jude Medical</td>
			<td>406128</td>
			<td>L: 12 cm</td>
		</tr>
		<tr>
			<td>Favorita II</td>
			<td>Aesculap</td>
			<td></td>
			<td>Type: GT104</td>
		</tr>
		<tr>
			<td>Fentanyl</td>
			<td>B. Braun</td>
			<td>71036</td>
			<td>50 mikrogram/mL</td>
		</tr>
		<tr>
			<td>Ketaminol Vet</td>
			<td>MSD/Intervet International B.V.</td>
			<td>511519</td>
			<td>100 mg/mL</td>
		</tr>
		<tr>
			<td>LabChart</td>
			<td>ADInstruments</td>
			<td></td>
			<td>Data aquisition software</td>
		</tr>
		<tr>
			<td>Lawton 85-0010 ZK1</td>
			<td>Lawton</td>
			<td></td>
			<td>Laryngoscope</td>
		</tr>
		<tr>
			<td>Lectospiral</td>
			<td>VYGON</td>
			<td>1159.90</td>
			<td>400 cm (Luer-LOCK)</td>
		</tr>
		<tr>
			<td>Lubrithal eye gel</td>
			<td>Dechra, Great Britain</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>MBH qufora</td>
			<td>MBH-International A/S</td>
			<td>13853401</td>
			<td>Urine bag</td>
		</tr>
		<tr>
			<td>Natriumklorid</td>
			<td>Fresenius Kabi</td>
			<td>7340022100528</td>
			<td>9 mg/ml Isotonic saline</td>
		</tr>
		<tr>
			<td>PICO50 Aterial Blood Sampler</td>
			<td>Radiometer</td>
			<td>956-552</td>
			<td>2 mL</td>
		</tr>
		<tr>
			<td>Portex Tracheal Tube</td>
			<td>Smiths Medical</td>
			<td>100/150/075</td>
			<td>&#34;Cuffed Clear Oral/Nasal Murphy Eye&#34;</td>
		</tr>
		<tr>
			<td>PowerLab 16/35</td>
			<td>ADInstruments</td>
			<td>PL3516</td>
			<td>Serial number: 3516-1841</td>
		</tr>
		<tr>
			<td>Pressure Extension set</td>
			<td>CODAN</td>
			<td>7,14,020</td>
			<td>Tube for anesthetics, 150 cm long, inner diameter 0.9 mm</td>
		</tr>
		<tr>
			<td>Propolipid</td>
			<td>Fresenius Kabi</td>
			<td>21636</td>
			<td>Propofol, 10 mg/mL</td>
		</tr>
		<tr>
			<td>PTS-X</td>
			<td>NuMED Canada Inc.</td>
			<td>PTSX253</td>
			<td>Inferior vena cava balloon</td>
		</tr>
		<tr>
			<td>Radiofocus Introducer II</td>
			<td>Radiofocus/Terumo</td>
			<td>RS+B80N10MQ</td>
			<td>6+7+8F sheaths</td>
		</tr>
		<tr>
			<td>Rompun Vet</td>
			<td>Beyer</td>
			<td>86450917</td>
			<td>Xylazin, 20 mg/mL</td>
		</tr>
		<tr>
			<td>R&#252;sch Brilliant AquaFlate Glycerine</td>
			<td>Teleflex</td>
			<td>178000</td>
			<td>Bladder catheter, size 14</td>
		</tr>
		<tr>
			<td>S/5 Avance</td>
			<td>Datex-Ohmeda</td>
			<td>-</td>
			<td>Mechanical ventilator</td>
		</tr>
		<tr>
			<td>Safersonic Conti Plus &#38; Safergel</td>
			<td>SECMA medical innovation</td>
			<td>SAF.612.18120.WG.SEC</td>
			<td>18 x 120 cm (Safersonic Sterile Transducer Cover with Adhesive Area and Safergel)</td>
		</tr>
		<tr>
			<td>Scisense Catheter</td>
			<td>Transonic Scisense</td>
			<td>FDH-5018B-E245B</td>
			<td>Serial number: 50-533. Pressure-volume catheter</td>
		</tr>
		<tr>
			<td>Scisense Pressure-Volume Measurement System</td>
			<td>Transonic Scisense</td>
			<td>ADV500</td>
			<td>Model: FY097B. Pressure-volume box</td>
		</tr>
		<tr>
			<td>Swan-Ganz CCOmbo</td>
			<td>Edwards Lifesciences</td>
			<td>744F75</td>
			<td>110 cm</td>
		</tr>
		<tr>
			<td>TruWave Pressure Monitoring Set</td>
			<td>Edwards Lifesciences</td>
			<td>T434303A</td>
			<td>210 cm</td>
		</tr>
		<tr>
			<td>Vivid iq</td>
			<td>GE Medical Systems China</td>
			<td>Vivid iq</td>
			<td></td>
		</tr>
		<tr>
			<td>Zoletil 50 Vet (tiletamin 125 mg and zolazepam 125 mg)</td>
			<td>Virbac</td>
			<td>83046805</td>
			<td>Zoletil Mix for pigs: 1 vial of Zoletil 50 Vet (dry matter); add 6.25 mL Xylozin (20 mg/mL), 1.25 mL ketamin (100 mg/mL) and 2.5 mL Butorphanol (10 mg/mL). Dose for pre-anesthesia: 10 mL/10 kg as intramuscular injection</td>
		</tr>
	</tbody>
</table>

closed chest biventricular pressure-volume loop recordings with admittance catheters in a porcine model

压力容积 （PV） 回路记录可对心室表现的负荷无关变量进行最先进的研究。单心室评估通常在临床前研究中进行。然而，由于左右心室的平行和连续连接，左右心室发挥功能上的相互依存性，鼓励同时评估两个心室。此外，各种药物干预可能会以不同的方式影响心室及其前负荷和后负荷。 
我们描述了在急性右心室 （RV） 超负荷的猪模型中，对基于入院的双心室 PV 环记录的闭胸方法。我们利用微创技术，所有血管通路均由超声波引导。PV导管在荧光镜引导下放置，以避免动物开胸，因为闭合胸部进路可维持相关的心肺生理学。导纳技术提供实时PV环路记录，无需事后处理。此外，我们还解释了在所介绍过程的关键时间点的一些基本故障排除步骤。 
所提出的方案是一种可重复且生理相关的方法，可在大型动物模型中获得双心室心脏PV环记录。这可以应用于各种各样的心血管动物研究。

本说明描述了一种在大型动物中实现来自RV和LV的基于导纳的PV记录的方法。
为了比较我们在RV和LV中的同时PV记录，我们对来自我们最大研究的双心室CO测量值进行了线性回归18 ，同时进行RV CO和LV CO测量的数量最多（来自12只动物的n = 379个记录）。我们发现斜率为1.03（95%CI 0.90-1.15），Y截距为695（95%CI -2-1392），r2= 0.40。这表明每个心室中PV导管测量的CO...

Watch this Scientific Journal Video about Closed Chest Biventricular Pressure-Volume Loop Recordings with Admittance Catheters in a Porcine Model at JoVE.com

Closed Chest Biventricular Pressure-Volume Loop Recordings with Admittance Catheters in a Porcine Model

在这里，我们提出了一种闭合胸部方法，用于急性右心室功能不全猪的基于入院的双室压力 - 体积环记录。

猪模型中闭合胸部双心室压力-体积循环记录与导管

Pressure-volume (PV) loop recording enables the state-of-the-art investigation of load-independent variables of ventricular performance. Uni-ventricular ...

这种获得双心室压力-体积环记录的闭合胸部方法能够在体内猪模型中进行最先进的血流动力学评估。这种微创方法的主要优点是，它允许对心血管系统进行彻底和独立于负荷的评估，同时保持近乎完整的胸部生理学。这种双心室评估方法对于大多数实验性心血管模型非常重要，因为左心和右心可能有不同的作用，例如，在药理学刺激上。同时，左心和右心之间可能存在相互依赖性，因此同时评估两个心室非常重要。麻醉后，使用17号无菌静脉导管刺穿皮肤。在超声波的帮助下引导针头进行血管内定位。使用Seldinger技术用导丝替换针头。取出静脉导管，只留下导丝在血管内腔内。为了便于鞘的插入，在导线上做一个小的皮肤切口。然后使用Seldinger技术将适当尺寸的护套放在导线上并放入所选的容器中。将 Swan-Ganz 导管通过八个法式鞘插入右颈静脉。使用胸腔镜检查观察 Swan-Ganz 导管的远端部分何时因球囊的无阻力膨胀而脱离鞘。慢慢地推进斯旺-甘茨导管。观察远端端口的压力信号在进入右心室时以及远端端口通过肺动脉后不久的变化。放气球囊，使用胸腔镜检查和压力信号确保远端压力端口仍在主肺动脉中。在左颈静脉的七个法国鞘中插入一根长导丝，然后将导丝推进穿过上中央静脉，右心房和下腔静脉，使用胸腔镜检查监测运动。将导丝留在静脉循环中，取出七个法式鞘并压缩入口点以避免出血。然后使用Seldinger技术将七个法国鞘换成16个法国鞘。将16法式护套推进到导线上，直到护套的尖端达到上腔静脉的水平。将压力容积导管插入16法式鞘中，然后将其推进到右心房。将16个法式鞘的外端向下和向内指向，这将指向鞘的前部。将压力容积导管从右心房推进到更前方的右心室。通过压力通量导管到典型心室形状的压力信号变化以及压力容积导管与右心室顶点相遇时的触觉阻力来验证这一点。最后，为了避免位于心脏附近的装置的任何血流动力学或电影响，一旦导管进入右心室，就将16个法国鞘缩回胸腔外。将八个法国鞘中的压力容积导管插入左颈动脉。在荧光透视的指导下，将压力容积导管通过八个法国鞘向主动脉瓣推进。为了通过开放的主动脉瓣推进压力容积导管，请将压力容积导管的快速推进同步到心脏周期的收缩期。通过观察从 PV 导管到典型心室形状的压力信号变化来验证成功与否。将导丝从股静脉推进到横膈膜水平的下腔静脉，然后将球囊插入导线上，使其在末端呼气时将其推进到膜片水平。检查是否从两个心室接收到最佳相位和幅度信号。确保两个心室压力容积回路均具有正确的形状、逼真的压力和容积。记录超过 30 至 60 秒连续通气的压力容积循环，并使用所有呼吸周期的平均值进行分析。对于与负载无关的压力- 体积变量，请屏住呼吸。等待几次心跳，然后用所选液体缓慢地给下腔静脉气球充气。观察右心室压力-容积环逐渐变小并向左移动。保持下腔静脉球囊充气足够长的时间，以减少右心室输出量，从而减少左心室预负荷，并观察左心室压力和容量的逐渐下降。从左心室获得的可接受的压力容积环应具有经典的方形形状，而从右心室获得的可接受的压力容积环应具有经典的三角形形状。如果从左心室或右心室获得次优环路，则需要调整压力容积导管以提高环路的质量。从右心室获得经典的三角形环更加困难，并且由于舒张末期的血液湍流引起的一些静态噪声是可以接受的。两个心室连续连接，导致前负荷减少的时间变化，因为下腔静脉球囊迅速降低右心室前负荷，但左心室前负荷不会减少，直到右心室输出量因缺乏前负荷而减少。前负荷逐渐减少导致一系列环路，左心室和右心室的体积和压力逐渐减少。插入右侧压力容积导管可能很困难，但通过练习，任何人都可以学习它。重要的是，必须花费必要的时间来优化导管定位以获得可靠的数据。该方法可以彻底评估心血管动物模型和干预措施的效果。血流动力学检查可辅以影像学检查和血液样本，以模拟临床病情检查。

Research

JoVE Journal

Medicine

A Murine Closed-chest Model of Myocardial Ischemia and Reperfusion

闭胸鼠心肌缺血再灌注模型

Surgical trauma by thoracotomy in open-chest models of coronary ligation induces an immune response which modifies different mechanisms involved in ...

科研

医学

Measurement of the Pressure-volume Curve in Mouse Lungs

In recent decades the mouse has become the primary animal model of a variety of lung diseases. In models of emphysema or fibrosis, the essential ...

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique

室颤由传统的封闭胸技术大鼠模型和复苏

A rat model of electrically-induced ventricular fibrillation followed by cardiac resuscitation using a closed chest technique that incorporates the basic ...

Cardiac Catheterization in Mice to Measure the Pressure Volume Relationship: Investigating the Bowditch Effect

心导​​管在小鼠测量压力体积的关系：调查的影响鲍迪奇

Animal models that mimic human cardiac disorders have been created to test potential therapeutic strategies. A key component to evaluating these ...

A Novel Microsurgical Model for Heterotopic, En Bloc Chest Wall, Thymus, and Heart Transplantation in Mice

一种新的显微模型异位，整块胸壁，胸腺，和心脏移植小鼠

Exploration of novel strategies in organ transplantation to prolong allograft survival and minimizing the need for long-term maintenance immunosuppression ...

Improvement of a Closed Chest Porcine Myocardial Infarction Model by Standardization of Tissue and Blood Sampling Procedures

组织和采血程序标准化改善闭合性胸猪心肌梗死模型的研究

Myocardial ischemia reperfusion (I/R) injury contributes to almost half of the necrotic area after myocardial infarction. To date there is no approved ...

A Closed-chest Model to Induce Transverse Aortic Constriction in Mice

诱导小鼠横向主动脉狭窄的闭合胸模型

Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to ...

Real-time Pressure-volume Analysis of Acute Myocardial Infarction in Mice

小鼠急性心肌梗死的实时压力容积分析

Acute myocardial infarction can lead to acute heart failure and cardiogenic shock. The evaluation of hemodynamics is critical for the evaluation of any ...

The Generation of Closed Femoral Fractures in Mice: A Model to Study Bone Healing

小鼠闭合性股骨骨折的形成: 骨愈合模型的研究

Bone fractures impose a tremendous socio-economic burden on patients, in addition to significantly affecting their quality of life. Therapeutic strategies ...

Biventricular Assessment of Cardiac Function and Pressure-Volume Loops by Closed-Chest Catheterization in Mice

小鼠闭胸导管插入术对心功能和压力-容积环的双心室评估

Assessment of cardiac function is essential to conduct cardiovascular and pulmonary-vascular preclinical research. Pressure-volume loops (PV loops) ...