Comprehensive echocardiographic protocol for pigs with emphasis on diastolic function: advantages over MRI assessment

Swine are increasingly used in cardiovascular research due to their anatomical and physiological similarities to humans, particularly for studying diastolic dysfunction. Although MRI offers excellent structural imaging, echocardiography provides superior real-time assessment of diastolic parameters. To address the lack of standardized methods and reduce variability across studies, we present a comprehensive guide for performing echocardiography in Yorkshire pigs, detailing anatomical considerations, equipment requirements, and technical approaches. We describe systematic approaches for obtaining and optimizing right parasternal long- and short-axis views, apical four-chamber, and subcostal imaging windows, with specific attention to anatomical variations from human cardiac orientation and standard clinical transducer positioning. These tomographic views enable a comprehensive assessment of systolic and diastolic function, including ventricular volumes, wall thicknesses, chamber dimensions, ejection fraction, and Doppler measurements of blood flow and tissue velocities. This standardized methodology for echocardiographic images acquisition enhances data reliability in cardiovascular pig models, improving the interpretation of preclinical study results and strengthening translational research outcomes. The protocol also provides consistency for veterinary applications, making echocardiography a preferred modality for longitudinal studies in this valuable translational model.NEW & NOTEWORTHY Anatomical positioning: porcine heart is more central and caudal than human heart; apical views are obtained at sixth to seventh intercostal space; right parasternal views are most reliable in pigs. Technical requirements are as follows: standardized sedation protocol is essential; specialized veterinary procedure table; and integrated electrocardiogram (ECG) monitoring for timing. Clinical value: excellent translational model for cardiovascular research; regular protocol adjustment based on animal size.