Validação das ferramentas ecográficas de Teicholz e Somatória dos Discos (Simpson Modificado) para o cálculo do débito cardíaco em jumentos nordestinos (Equus asinus)
Carregando...
Data
2021-08-24
Autores
Nunes, Pedro Henrique Dias
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Pelo presente avaliou-se a eficácia dos métodos ecocardiográficos da somatória dos discos (Simpson modificado) e de Theicholz, não invasivos, em estimar o débito cardíaco (DC) de jumentos nordestinos (Equus asinus) frente ao método da Termodiluição. Além disso, foram apresentados valores basais da funcionalidade do ventrículo esquerdo determinados por meio do doppler tecidual. Para a obtenção do DC foram realizados os métodos direto (termodiluição) e indiretos (somatória dos discos de Simpson e Theicholz), pela ecocardiografia. As análises foram conduzidas em cinco animais distintos e os valores registrados em quadruplicata, com intervalo mínimo de sete dias entre as avaliações. Observou-se correlação (Spearman) moderada entre os métodos de Simpson e Theicholz (rs = 0,452, p = 0,045) e entre os métodos de Termodiluição e Simpson (rs = 0,423, p = 0,062), e ausência de correlação entre os métodos de Termodiluição e Theicholz (rs = 0,283, p = 0,223). A análise de concordância entre métodos distintos por Bland-Altman demonstrou haver melhor relação entre a Termodiluição e Simpson (viés = - 1,70 e DP = 3,24), em relação à Termodiluição e Theicholz (viés = - 6,09 e DP = 3,04) e Simpson e Theicholz (viés = - 4.38 e DP = 2,32). Do mesmo modo, pelo método de regressão linear observou-se não haver propensão dos métodos de Simpson (p = 0,217) e Theicholz (p = 0,954) em superestimar ou subestimar os valores do DC, obtidos pela Termodiluição. Por outro lado, há tendência do método de Theicholz (p = 0,061) em superestimar ou subestimar os valores do DC obtidos pelo método de Simpson. A análise de regressão ordinária dos produtos mínimos (ROPM) revelou ausência de viés fixo e presença de viés proporcional entre os métodos de Simpson e Theicholz e Termodiluição e Theicholz e ausência de viés fixo e viés proporcional entre a Termodiluição e Simpson. A funcionalidade do ventrículo esquerdo foi avaliada pelo doppler tecidual e seus valores basais foram apresentados, como se segue: velocidade de contração isovolumétrica (MS’I) = 0,097 m/s ± 0,011; velocidade de relaxamento inicial (ME'I) = -0,135 m/s ± 0,007; velocidade de relaxamento final (MA'I) = -0,093 m/s ± 0,019; tempo de relaxamento (E’/A’I) = 1,52 ± 0,32; tempo de duração do relaxamento isovolumétrico (IVRT) = 108,85 m/s ± 9,85; tempo de duração da contração isovolumétrico (IVCT) = 181,13 m/s ± 36,56, tempo de contração (CT) = 267,6 m/s ± 22,5 e índice de desempenho do miocárdio (IPM) = 1,08 ± 0,15.
The present study evaluated the effectiveness of the echocardiographic method of the sum of the discs (modified Simpson) and Theicholz, non-invasive, in estimating the cardiac output of northeastern donkeys (Equus asinus) compared to the Thermodilution method. In addition, baseline values of left ventricular functionality were determined using tissue doppler. To obtain cardiac output, direct (thermodilution) and indirect (sum of Simpson and Theicholz) methods were performed using echocardiography. The analyzes were conducted on five different animals and the values were recorded in quadruplicate, with a minimum interval of seven days between evaluations. A moderate Spearman correlation was observed between the Simpson and Theicholz methods (rs = 0.452, p = 0.045), Thermodilution and Simpson methods (rs = 0.423, p = 0.062), and no correlation between the methods of Thermodilution and Theicholz (rs = 0.283, p = 0.223). The analysis of agreement between different methods by Bland-Altman showed a better relationship between Thermodilution and Simpson (bias = - 1.70 and SD = 3.24), compared to Thermodilution and Theicholz (bias = - 6.09 and SD = 3.04) and Simpson and Theicholz (bias = - 4.38 and SD = 2.32). Likewise, by the linear regression method, it was observed that the Simpson (p = 0.217) and Theicholz (p = 0.954) methods did not tend to overestimate or underestimate the CO values obtained by Thermodilution. On the other hand, there is a tendency for the Theicholz method (p = 0.061) to overestimate or underestimate the CO values obtained by the Simpson method. Ordinary regression analysis of the minimum products revealed absence of fixed bias and presence of proportional bias between the methods of Simpson and Theicholz and Thermodilution and Theicholz and absence of fixed and proportional bias between Thermodilution and Simpson. Left ventricular functionality was assessed by tissue doppler and its baseline values were presented, isovolumetric contraction speed (MS'I) = 0.097 m/s ± 0.011; initial relaxation speed (ME'I) = -0.135 m/s ± 0.007; final relaxation speed (MA'I) = -0.093 m/s ± 0.019; relaxation time (E ’/ A’I) = 1.52 ± 0.32; duration of isovolumetric relaxation (IVRT) = 108.85 m/s ± 9.85; duration of isovolumetric contraction (IVCT) = 181.13 m/s ± 36.56, contraction time (CT) = 267.6 m/s ± 22.5 and myocardial performance index (IPM) = 1.08 ± 0.15.
The present study evaluated the effectiveness of the echocardiographic method of the sum of the discs (modified Simpson) and Theicholz, non-invasive, in estimating the cardiac output of northeastern donkeys (Equus asinus) compared to the Thermodilution method. In addition, baseline values of left ventricular functionality were determined using tissue doppler. To obtain cardiac output, direct (thermodilution) and indirect (sum of Simpson and Theicholz) methods were performed using echocardiography. The analyzes were conducted on five different animals and the values were recorded in quadruplicate, with a minimum interval of seven days between evaluations. A moderate Spearman correlation was observed between the Simpson and Theicholz methods (rs = 0.452, p = 0.045), Thermodilution and Simpson methods (rs = 0.423, p = 0.062), and no correlation between the methods of Thermodilution and Theicholz (rs = 0.283, p = 0.223). The analysis of agreement between different methods by Bland-Altman showed a better relationship between Thermodilution and Simpson (bias = - 1.70 and SD = 3.24), compared to Thermodilution and Theicholz (bias = - 6.09 and SD = 3.04) and Simpson and Theicholz (bias = - 4.38 and SD = 2.32). Likewise, by the linear regression method, it was observed that the Simpson (p = 0.217) and Theicholz (p = 0.954) methods did not tend to overestimate or underestimate the CO values obtained by Thermodilution. On the other hand, there is a tendency for the Theicholz method (p = 0.061) to overestimate or underestimate the CO values obtained by the Simpson method. Ordinary regression analysis of the minimum products revealed absence of fixed bias and presence of proportional bias between the methods of Simpson and Theicholz and Thermodilution and Theicholz and absence of fixed and proportional bias between Thermodilution and Simpson. Left ventricular functionality was assessed by tissue doppler and its baseline values were presented, isovolumetric contraction speed (MS'I) = 0.097 m/s ± 0.011; initial relaxation speed (ME'I) = -0.135 m/s ± 0.007; final relaxation speed (MA'I) = -0.093 m/s ± 0.019; relaxation time (E ’/ A’I) = 1.52 ± 0.32; duration of isovolumetric relaxation (IVRT) = 108.85 m/s ± 9.85; duration of isovolumetric contraction (IVCT) = 181.13 m/s ± 36.56, contraction time (CT) = 267.6 m/s ± 22.5 and myocardial performance index (IPM) = 1.08 ± 0.15.
Descrição
Palavras-chave
Asinino, Cardiologia, Débito cardíaco, Ecocardiografia