Transthoracic echocardiography for evaluating cardiac parameters in growing piglets

Large animal model research is a vital step in the pre-clinical testing of new therapeutic interventions in congenital heart disease to ensure that they are safe and effective before clinical trials are begun. Although swine hearts are an excellent model for the study of cardiovascular disease due to their anatomical and physiological similarities with human hearts, there are differences in body habitus and internal organ positioning that necessitate a deviation from standard human echocardiography protocols. Previously published data on swine echocardiography has focused on mature animals and a standardized protocol for serial valvar assessment is lacking. The aim of this study was to create a protocol for a complete sedated piglet transthoracic echocardiogram. The protocol is designed for the evaluation of ventricular size and function and detailed evaluation of all cardiac valves. Additionally, we demonstrate implementation of this protocol by reporting normative growth trends of semilunar valves and left ventricular dimensions in piglets studied in our research lab. The goal of this standardized protocol is to allow for further cardiovascular research on growing piglets, particularly in the field of partial heart transplantation. Standardized views for valve measurements enable reproducibility across observers and across serial follow-up to reliably assess hemodynamic function and growth over time.