Assessment of skeletal muscle ventricle tissue blood flow using positron emission tomography.

In this pilot study, we assessed the feasibility of using positron emission tomography (PET) imaging for in vivo measurement of skeletal muscle ventricle (SMV) tissue blood flow. In 4 dogs, with SMVs prepared from their latissimus dorsi muscle, we quantified SMV tissue blood flow by PET and related it to the tissue flow measured by radiolabeled microspheres under similar physiologic conditions. The tissue blood flow was estimated in SMVs wrapped around a mandrel (not in circulation) at rest and during SMV stimulation (30 and 90 contraction-cycles/min). SMV tissue perfusion was heterogeneous, especially during SMV contraction. Furthermore, there was a linear relationship between SMV tissue flows estimated by PET and those measured by microspheres. We conclude that in vivo imaging of SMV is feasible by PET. Quantification of SMV tissue blood flow by PET has promise as a means of assessing changes in blood flow, but further technical progress needs to be made before absolute flows can be reliably measured.

Assessment of skeletal muscle ventricle function using tissue velocity imaging.

BACKGROUND AND AIMS: Skeletal muscle ventricles (SMVs) are a potential power source for circulatory assistance. Noninvasive assessment of SMVs is desirable in long-term studies of SMV function. This study evaluated whether tissue velocity imaging (TVI) indices of function correlate with invasive measurements of output and pressure generation and examined the potential of TVI to provide information about SMV geometry and wall contraction characteristics. METHODS: SMVs were constructed in six sheep. After electrical conditioning, SMVs were connected to a mock circulation and stimulated with supramaximal 30-Hz and 50-Hz bursts to contract 35 times/min. The SMVs were tested over a range of preloads, and afterload was adjusted to simulate systemic (80 mmHg) and right ventricular (30 mmHg) loading conditions. Stroke volume and pressure were measured invasively, and stroke work was calculated. TVI was used to measure velocities in two opposing SMV walls, providing a simple wall motion score (WMS). This was evaluated against stroke volume, stroke work, and pressure development. RESULTS: 50-Hz stimulation frequency and high preload optimized SMV performance. Optimal SMV performance indices (mean at 50 Hz) were as follows: (a) right ventricular loading conditions (preload 30 mmHg), stroke volume 17.6 mL (SEM 3.2), peak pressure over afterload 44.2 mmHg (10.9), stroke work 0.05 J (0.02); (b) systemic loading conditions (preload 60 mmHg), stroke volume 10.1 mL (3.2), peak pressure over afterload 58 mmHg (14.6), stroke work 0.08 J (0.03). With low preloads, geometric anomalies were noted in the SMVs using TVI. Collapse of the SMVs and dyskinesis were observed, which normalized with higher preloads. Persistent dyskinesis was noted in one SMV and was associated with poor performance. Correlations (at optimal loading and stimulation settings) were as follows: systemic loading conditions, stroke volume versus WMS, 0.92 (p = 0.026); peak pressure versus WMS 0.89 (p = 0.045); stroke work versus WMS, r = 0.91 (p = 0.046). Right ventricular loading conditions were as follows: stroke volume versus WMS, 0.63 (p = 0.25); peak pressure versus WMS, 0.66 (p = 0.22); stroke work versus WMS, 0.45 (p = 0.39). CONCLUSION: Under systemic loading conditions, TVI indices of SMV wall motion mirror invasive indices of performance, suggesting that TVI may be a useful tool for long-term noninvasive monitoring of SMV function.