斑点追踪显像联合心肌造影评价兔急性心肌缺血早期左室心肌功能的变化
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常州市卫生计生委重大科技项目(ZD201605)


Changes of left ventricular myocardial function in the early stage of acute myocardial ischemia in rabbits using speckle tracking imaging and myocardial contrast echocardiography
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    目的:联合应用斑点追踪显像(speckle tracking imaging,STI)技术与心肌造影(myocardial contrast echocardiography,MCE)技术测量左室应变值及心肌灌注参数,评价兔急性心肌缺血早期心肌功能的变化。方法:新西兰大白兔36只,麻醉后开胸行冠状动脉左室支结扎以构建兔急性心肌缺血模型。开胸前及关胸后10 min均在造影模式(Low MI模式)下采集胸骨旁左室长轴及心尖两腔、三腔、四腔心切面各15个心动周期的动态二维图像。应用STI技术分析左室整体及局部纵向收缩期峰值应变;应用MCE技术分析左室心肌灌注参数:局部微血管血容量(A)、局部血流速度(β)、局部心肌血流量(myocardial blood flow,MBF)。结果:左室整体收缩期峰值应变术后较术前显著降低(P<0.05);左室前壁、前间隔、侧壁、后壁、中间段下壁及整个心尖部纵向收缩期峰值应变术后均降低(P<0.05)外。整个左室心肌灌注参数A、β、MBF术后与术前相比均降低,除下壁及后间隔的A值差异无统计学意义(P>0.05)外,其余差异均有统计学意义(P<0.05)。结扎前后左室各壁纵向收缩期峰值应变变化率与局部心肌血流量变化率均呈正相关(r=0.58、0.56、0.65、0.62、0.56、0.36,P均<0.05)。结论:STI技术联合MCE技术能敏感地评价急性心肌缺血早期心肌功能的变化。

    Abstract:

    Objective:Combined speckle tracking imaging(STI)and myocardial contrast echocardiography(MCE)to evaluate myocardial function of left ventricular(LV)in the early stage of acute myocardial ischemia(AMI)in rabbits by measuring the LV strain and myocardial perfusion parameters. Methods:A total of 36 New Zealand white rabbits were enrolled in this experiment,the LV branch of coronary artery was ligated in order to establish an AMI model. In the low MI mode,15 cardiac cycles of parasternal LV long-axis,apical four-,three- and two-chamber views were acquired before operation(which was called the preoperation group)and 10 minutes after AMI(which was called the postoperation group)for analysis. Global and segmental peak systolic longitudinal strain(LS)of LV walls was analyzed by STI. Myocardial blood volume(A),velocity(β)and myocardial blood flow(MBF)were analyzed by MCE. Results:There were significant differences in GLS and LS of left anterior septum wall,anterior wall,lateral wall,posterior wall,inferior middle wall,and apex sections between the preoperation and postoperation groups,the values in the postoperation group were significantly lower than those in the preoperation group(P<0.05). The myocardial perfusion parameters of LV between the postoperation and preoperation groups had significant differences(P<0.05)except the A value of inferior and posterior septum wall. The changes of LS percent were positively correlated with MBF of left anterior septum,anterior,lateral,inferior,posterior,and posterior septum walls(r were 0.58,0.56,0.65,0.62,0.56,0.36,P<0.05). Conclusion:Combined STI and MCE can reflect the changes of LV myocardial function in the early stage of acute myocardial ischemia sensitively.

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崔 灵,颜紫宁,范 莉,刘 畅,沈 丹,黄 俊.斑点追踪显像联合心肌造影评价兔急性心肌缺血早期左室心肌功能的变化[J].南京医科大学学报(自然科学版),2020,(1):39-44

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  • 收稿日期:2019-05-29
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  • 在线发布日期: 2020-02-09
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