CAJ | 학술논문

目的应用斑点追踪成像技术评价不同电机械激动顺序下收缩期左室跨壁扭转运动特征.方法 5只开胸比格犬模型,分别在基础(BASE),右心耳(RAA)、右室心尖(RVA)、左室侧壁(LVL)和左室心尖(LVA)起搏状态采集左室心尖、基底短轴和四腔心图像.QLAB软件分析短轴切面心内膜下、心外膜下和整体旋转角度(RA)及节段角位移(AE),计算左室扭转及射血分数(EF).结果 ①RAA组心内膜下、心外膜下和整体扭转,基底和心尖水平心内膜下、心外膜下和整体RA及AE与BASE组间差异无统计学意义(P>0.05);②RVA组心内膜下、心外膜下和整体扭转及LVA组心内膜下和整体扭转均小于RAA组(P<0.05);RVA和LVA组基底心内膜下、心外膜下和整体RA均小于RAA组(P<0.05);③心室起搏后起搏位点相邻节段心肌AE小于RAA组(P<0.05);④BASE状态心内膜下扭转大于心外膜下(P<0.05),起搏仅呈心内膜下扭转大于心外膜下趋势(P>0.05);⑤BASE组与RAA组心外膜下和整体扭转与左室EF呈正相关;基底心内膜下、心外膜下和整体RA与左室EF呈正相关.结论 RVA及LVA起搏明显抑制左室跨壁扭转运动;正常激动顺序下左室整体及外膜下心肌扭转和基底旋转运动与左室EF关系密切.
목적 응용반점추종성상기술평개불동전궤계격동순서하수축기좌실과벽뉴전운동특정.방법 5지개흉비격견모형,분별재기출(BASE),우심이(RAA)、우실심첨(RVA)、좌실측벽(LVL)화좌실심첨(LVA)기박상태채집좌실심첨、기저단축화사강심도상.QLAB연건분석단축절면심내막하、심외막하화정체선전각도(RA)급절단각위이(AE),계산좌실뉴전급사혈분수(EF).결과 ①RAA조심내막하、심외막하화정체뉴전,기저화심첨수평심내막하、심외막하화정체RA급AE여BASE조간차이무통계학의의(P>0.05);②RVA조심내막하、심외막하화정체뉴전급LVA조심내막하화정체뉴전균소우RAA조(P<0.05);RVA화LVA조기저심내막하、심외막하화정체RA균소우RAA조(P<0.05);③심실기박후기박위점상린절단심기AE소우RAA조(P<0.05);④BASE상태심내막하뉴전대우심외막하(P<0.05),기박부정심내막하뉴전대우심외막하추세(P>0.05);⑤BASE조여RAA조심외막하화정체뉴전여좌실EF정정상관;기저심내막하、심외막하화정체RA여좌실EF정정상관.결론 RVA급LVA기박명현억제좌실과벽뉴전운동;정상격동순서하좌실정체급외막하심기뉴전화기저선전운동여좌실EF관계밀절.
Objective To evaluate the mechanical characteristics of systolic left ventricular(LV) transmural torsion in different LV electro-mechanical patterns using speckle tracking imaging. Methods Five open-chest canine models were employed for the acquirement of the basal, apical short-axis and four-chamber views of LV during baseline(BASE) and right atrial appendage(RAA), right ventricular apical (RVA), left ventricular lateral wall (LVL) and left ventrieular apical (LVA) pacing. Subendocardial (subend),subepicardial(subepi) and bulk rotation angle(RA) and segmental angle excursion(AE) at basal and apical level were analyzed using a dedicated workstation. LV torsion at different layers and bulk and global LV ejection fraction (EF) were calculated. Results ① There were no significant difference of transmural torsion and RA at basal and apical level between BASE and RAA pacing (P>0.05);② LV torsion of subend, subepi and bulk during RVA pacing were lower than those during RAA pacing(P0.05);LV torsion of subend and bulk during LVA pacing were lower than those during RAA pacing(P0.05);LV RA of subend,subepi and bulk at basal level during RVA and LVA pacing were lower than those during RAA pacing (P<0.05); ③ For normal electro-mechanical pattern, LV torsion of subend were significant higher than that of subepi(P<0.05), there only were a higher tendency for all pacing models (P>0.05); ④AE of segments near the pacing site decreased during different ventricle paeings (P<0.05); ⑤At BASE and during RAA pacing, LV bulk and subepi torsion were positively correlated to EF; RA of subend,subepi and bulk at basal level were positively correlated to EF. Conclusions LV transmual torsion are significantly depressed during RVA and LVA pacing. There is a spatial co-relationship between LV EF and torsion and rotation of bulk and subepi at basal level in normal LV electro-mechanical patterns.