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Lo, Muzio, FP; Zirngast, B; Karner, B; Manninger, M; Fontana, M; Steendijk, P; Mächler, H; Rozzi, G; Alogna, A.
Intraoperative Evaluation of Right Ventricular Mechanics in a Pressure-Overload Swine Model.
J Appl Physiol (1985). 2025; Doi: 10.1152/japplphysiol.00143.2025
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Führende Autor*innen der Med Uni Graz
Alogna Alessio
Zirngast Birgit
Co-Autor*innen der Med Uni Graz
Mächler Heinrich
Manninger-Wünscher Martin
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Abstract:
OBJECTIVES: Assessment of right ventricular (RV) mechanical performance during open chest surgery is typically based on invasive methods and subjective evaluations. This study developed a porcine model of acute progressive RV pressure overload to evaluate hemodynamic changes and validate the 3D-video kinematic assessment of the Videocardiograph (VCG). METHODS: Seven healthy Landrace pigs were instrumented under fluoroscopic guidance with Swan-Ganz and RV conductance catheters. Following a median sternotomy, pulmonary artery banding (PB) was performed in two stages to induce minimal (PBmin) and maximal (PBmax) pressure overload. In a proof-of-concept experiment, different PB steps were performed to record both videos for the VCG and invasive pressure-volume assessments (PV-loop). Additionally, these videos were subjectively evaluated by five consultant surgeons, similar to clinical routine. RESULTS: PBmax significantly increased end-systolic pressure from baseline (21.17±3.31mmHg vs 39.85±7.82mmHg, p=0.001) and led to RV dilation, reduced ejection fraction (52.80±10.36% vs 33.99±9.88%, p=0.012), and decreased myocardial efficiency. In the proof-of-concept experiment, visual evaluations were highly variable among the cardiac surgeons, resulting in only a moderate reliability of their assessments (ICC=0.59 for RV-function; ICC=0.60 for filling status). VCG-derived epicardial z-axis displacements, systolic timing, diastolic velocity and volume demonstrated excellent relationships with PV-loop data. CONCLUSIONS: This study established a porcine model of progressive RV pressure overload with robust PV-loop assessment. VCG-derived epicardial kinematics reliably quantified RV mechanical activity and correlated with gold-standard hemodynamic measurements. This non-invasive, cost-effective method shows promise for early detection of acute RV dysfunction in the operating room and warrants further clinical investigation.

Find related publications in this database (Keywords)
kinematic assessment
porcine model
pressure overload
right ventricle
videocardiograph
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