Measurement of Pulmonary Transit Time by Echocardiography: Comparison With Cardiac MRI

Study Procedures The measurement of PTT and PBV has been described in detail in our prior protocol. These calculations and techniques are identical for the current study. In addition, we may place additional regions of interest (ROIs) during the off-line analysis, but this step would not influence the data acquisition during the TEE or the TEE procedure itself.

Note that placement of a peripheral intravenous (IV) catheter is standard-of-care for patients undergoing a TEE.

Acquisition and Analysis of Data:

The following is the anticipated flow of data acquisition and analysis:

1. Prior to or upon arrival to the TEE Suite, prospective patients will be screened by study personnel for informed consent.
2. After informed consent is obtained, the patient will undergo a focused TTE in the TEE Holding Room prior to the TEE. One or two doses of echocardiographic contrast will be administered to obtain PTT via TTE to facilitate comparison to PTT derived from TEE (Specific Aim #3). Prior to ultrasound contrast administration, an agitated saline injection will be given if intra-cardiac shunt is suggested by color Doppler evaluation. If a shunt is present, contrast would not be administered and the patient would be unenrolled from the study.
3. During the TEE, under direct supervision of an attending cardiac anesthesiologist and/or an attending cardiologist, up to 2 additional doses of echocardiographic contrast would be administered. A sub-set of patients will receive 2 doses to facilitate comparison of PTT obtained from different views (Specific Aim #2). This is analogous to our previous protocol in which multiple doses of contrast are administered in order to assess reproducibility of PTT measurements.
4. As part of standard-of-care, all patients that have completed a TEE are monitored in the TEE Suite for at least 30 minutes including assessment of blood pressure, heart rate, and oximetry.