中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2009年
4期
337-342
,共6页
LI Wen-hua%李文华%尹立雪%刘望彭%左明良%刘会若%郭智宇%白艳%钟毓%武彤%陆景
LI Wen-hua%李文華%尹立雪%劉望彭%左明良%劉會若%郭智宇%白豔%鐘毓%武彤%陸景
LI Wen-hua%리문화%윤립설%류망팽%좌명량%류회약%곽지우%백염%종육%무동%륙경
超声心动描记术%心肌缺血%心室功能,左%径向位移
超聲心動描記術%心肌缺血%心室功能,左%徑嚮位移
초성심동묘기술%심기결혈%심실공능,좌%경향위이
Echocardiography%Myocardial ischemia%Ventricular function,left%Radial displacement
目的 观察比格犬左心室急性心肌缺血前后,节段整体和节段跨壁心肌峰值径向位移(RD)变化,量化评价节段整体和节段跨壁心肌力学特征,为缺血前后不同状态心肌构造与功能的定量研究提供基础力学数据.方法 10只健康比格犬开胸模型,结扎冠状动脉左前降支,诱导产生急性心肌缺血.缺血前和结扎冠状动脉后20min分别采集三个心动周期二尖瓣水平、乳头肌水平以及心尖水平短轴观动态组织多普勒速度图像.应用量化组织多普勒工作站,分别获取各短轴观前壁、下间壁、下壁、后壁节段整体和心内膜下心肌(subend)、中层心肌(mid)、心外膜下心肌(subepi)的RD时间曲线并测量RD及其达峰值时间.评价急性心肌缺血前后节段整体和节段跨壁心肌的RD、达峰时间、达峰时间标准差等力学参数变化及其相关性.结果 ①急性心肌缺血后,二尖瓣水平前壁和乳头肌水平前壁及心尖水平各节段整体及节段跨壁心肌的RD较缺血前呈下降趋势,其余节段呈增高趋势;②急性心肌缺血后,左心室壁12节段跨壁的RD与相应节段整体的RD相关性较缺血前发生改变,乳头肌水平及心尖水平前壁节段跨壁与节段整体的RD相关性丧失.③急性心肌缺血后,左心室节段整体和节段跨壁的心率纠正后RD达峰时间较缺血前延迟.部分节段整体的RD达峰时间延迟较缺血前差异有统计学意义(P<0.05).④急性心肌缺血后,左心室节段整体和节段跨壁心肌的RD达峰时间标准差较缺血前增大,差异有统计学意义(P<0.05).结论 节段整体和跨壁心肌峰值RD降低、相关性破坏、达峰时间延迟、达峰时间标准差增大等终点力学参数变化能够反映急性心肌缺血局部的力学异常状态.
目的 觀察比格犬左心室急性心肌缺血前後,節段整體和節段跨壁心肌峰值徑嚮位移(RD)變化,量化評價節段整體和節段跨壁心肌力學特徵,為缺血前後不同狀態心肌構造與功能的定量研究提供基礎力學數據.方法 10隻健康比格犬開胸模型,結扎冠狀動脈左前降支,誘導產生急性心肌缺血.缺血前和結扎冠狀動脈後20min分彆採集三箇心動週期二尖瓣水平、乳頭肌水平以及心尖水平短軸觀動態組織多普勒速度圖像.應用量化組織多普勒工作站,分彆穫取各短軸觀前壁、下間壁、下壁、後壁節段整體和心內膜下心肌(subend)、中層心肌(mid)、心外膜下心肌(subepi)的RD時間麯線併測量RD及其達峰值時間.評價急性心肌缺血前後節段整體和節段跨壁心肌的RD、達峰時間、達峰時間標準差等力學參數變化及其相關性.結果 ①急性心肌缺血後,二尖瓣水平前壁和乳頭肌水平前壁及心尖水平各節段整體及節段跨壁心肌的RD較缺血前呈下降趨勢,其餘節段呈增高趨勢;②急性心肌缺血後,左心室壁12節段跨壁的RD與相應節段整體的RD相關性較缺血前髮生改變,乳頭肌水平及心尖水平前壁節段跨壁與節段整體的RD相關性喪失.③急性心肌缺血後,左心室節段整體和節段跨壁的心率糾正後RD達峰時間較缺血前延遲.部分節段整體的RD達峰時間延遲較缺血前差異有統計學意義(P<0.05).④急性心肌缺血後,左心室節段整體和節段跨壁心肌的RD達峰時間標準差較缺血前增大,差異有統計學意義(P<0.05).結論 節段整體和跨壁心肌峰值RD降低、相關性破壞、達峰時間延遲、達峰時間標準差增大等終點力學參數變化能夠反映急性心肌缺血跼部的力學異常狀態.
목적 관찰비격견좌심실급성심기결혈전후,절단정체화절단과벽심기봉치경향위이(RD)변화,양화평개절단정체화절단과벽심기역학특정,위결혈전후불동상태심기구조여공능적정량연구제공기출역학수거.방법 10지건강비격견개흉모형,결찰관상동맥좌전강지,유도산생급성심기결혈.결혈전화결찰관상동맥후20min분별채집삼개심동주기이첨판수평、유두기수평이급심첨수평단축관동태조직다보륵속도도상.응용양화조직다보륵공작참,분별획취각단축관전벽、하간벽、하벽、후벽절단정체화심내막하심기(subend)、중층심기(mid)、심외막하심기(subepi)적RD시간곡선병측량RD급기체봉치시간.평개급성심기결혈전후절단정체화절단과벽심기적RD、체봉시간、체봉시간표준차등역학삼수변화급기상관성.결과 ①급성심기결혈후,이첨판수평전벽화유두기수평전벽급심첨수평각절단정체급절단과벽심기적RD교결혈전정하강추세,기여절단정증고추세;②급성심기결혈후,좌심실벽12절단과벽적RD여상응절단정체적RD상관성교결혈전발생개변,유두기수평급심첨수평전벽절단과벽여절단정체적RD상관성상실.③급성심기결혈후,좌심실절단정체화절단과벽적심솔규정후RD체봉시간교결혈전연지.부분절단정체적RD체봉시간연지교결혈전차이유통계학의의(P<0.05).④급성심기결혈후,좌심실절단정체화절단과벽심기적RD체봉시간표준차교결혈전증대,차이유통계학의의(P<0.05).결론 절단정체화과벽심기봉치RD강저、상관성파배、체봉시간연지、체봉시간표준차증대등종점역학삼수변화능구반영급성심기결혈국부적역학이상상태.
Objective To evaluate the change of myocardial segment and the transmural peak radial displacement(RD) of left ventricular wall before and after acute myocardial isehemia. Methods Left anterior descending coronary artery was ligated to induce acute myocardial ischemia in 10 open-chest Beagle canine models. Two-dimensional gray-scale images with overlaid tissue Doppler velocity imaging in three short-axis views including mitral annulus(MV), papillary muscle(PM) and apical(AP) levels were acquired before and after acute myocardial ischemia in three complete cardiac cycles. Parameters including RD, RD peak time(RD-TC), standard deviation of RD peak time(RD-TSD) of anterior wall( AW), inferoseptal wall (IS) ,inferior wall(lW) and posterior wall(PW) at the 12 segments and different myocardial layers(i.e., subend,mid,subepi) of the same segment of left ventricle were measured and analyzed using quantification tissue Doppler imaging workstation and the difference and co-relationship among them were analyzed also. Results ①After acute myocardial ischemia, the segment and subend,mid, subepi RD of AW of MV, PW and AP were decreased,other counterpart segments were increased without significant difference(P>0.05). ②After acute myocardial ischemia, the existed RD co-relationship revealed between suhend, mid, subepi and the segment were changed(i, e. ,the co-relation in AM at PW and AP levels were vanished). ③Corrected by the heart rate, myocardial RD-Tc at all 12 segments and subend, mid, subepi after acute myocardial ischemia were longer than that before separately. ④ RD-TSD at the 12 segments, subend, mid, subepi were significantly wider after acute myocardial ischemia than that before(P<0.05). Conclusions The decreased RD,dis-connective spatial co-relationship of RD,delayed RD-Tc and wide RD-TSD can be used as potential mechanical parameters for the more sensitive evaluation of regional myocardial dysfunction during acute isehemia.
