Transpulmonary Contrast Echocardiographic Opacification of Left Ventricle and Its Hemodynamic Action: A Comparative Experimental Study between Albunex and Sonicated Human Albumin
松田 尚雄, 別府 慎太郎 , 中谷 敏, 太田 剛弘, 宮武 邦夫
Hisao MATSUDA, Shintaro BEPPU, Satoshi NAKATANI, Takahiro OHTA, Kunio MIYATAKE
National Cardiovascular Center Research Institute
Albunex, Sonicated hunikn albumin, Transvenous left ventricular opacification, Hemodynamic action
In anesthetized open-chest dogs, transvenous left ventricular opacification with a newly developed echographic contrast medium, Albunex (ANX) , and its hemodynamic action were examined at the dose range of 0.05-1.0 ml/kg in comparison with sonicated human albumin (s-ALB) at the dose range
of 0.025-0.5 ml/kg.
Transvenous left ventricular opacification was evaluated by means of visually semi-quantified grade and duration. Although in both of these indices, there was no significant difference between ANX and s-ALB, the reproducibility at the same dose was higher in ANX than in s-ALB. In addition, the appearance rate of acoustic shadow in the left ventricular cavity was higher in ANX than in S-ALB.
With respect to the actions on arterial oxygen saturation and hemodynamics, ANX did not decrease arterial oxygen saturation in the dose range of 0.05-1.0 ml/kg, while s-ALB did decrease saturation at doses over 0.25 ml/kg under normal ventilatory conditions. Under hypoventilatory conditions, however, ANX at doses over 0.5 ml/kg decreased arterial oxygen saturation as did s-ALB. At doses over 0.5 ml/kg both ANX and s ALB evoked significant but slight elevation in systolic pulmonaryarterial pressure, whereas only ANX at doses over 0.25 ml/kg did induce significant and substantial elevation in peak systolic left ventricular pressure. The increase in peak systolic left ventricular pressure induced by ANX was significantly larger than that induced by non-sonicated human albumin employed as a control solution at the same dose. This indicated another mechanism in addition to the volume effect.
This experimental study showed that ANX had higher reproducibility in transvenous left ventricular opacification than s-ALB did without affecting arterial oxygen saturation under normal ventilatory conditions. However, at relatively high doses ANX significantly elevated peak left ventricular pressure, and under hypoventilatory conditions it significantly decreased arterial oxygen saturation.