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
10期
875-881
,共7页
郭智宇%尹立雪%左明良%刘会若%白艳%钟毓%李文华%孟庆国%武彤%王俊丽
郭智宇%尹立雪%左明良%劉會若%白豔%鐘毓%李文華%孟慶國%武彤%王俊麗
곽지우%윤립설%좌명량%류회약%백염%종육%리문화%맹경국%무동%왕준려
超声心动描记术%心肌缺血%心脏起搏%人工%斑点追踪显像
超聲心動描記術%心肌缺血%心髒起搏%人工%斑點追蹤顯像
초성심동묘기술%심기결혈%심장기박%인공%반점추종현상
Echocardiography%Myocardial ischemia%Cardiac pacing%artificial%Speckle tracking imaging
目的 采用超声斑点追踪成像技术评价急性心肌缺血前后右心耳起搏与右室心尖起搏模式下左心室心肌力学状态.方法 结扎冠状动脉左前降支建立急性心肌缺血比格犬模型.获取14只开胸犬急性心肌缺血前后窦性心律及两种起搏状态的标准左心室长轴切面;分别测量和计算左心室整体长轴应变及18节段长轴峰值应变、应变达峰时间、应变达峰时间标准差;进行不同研究者间和研究者自身重复性相关分析.结果 ①急性心肌缺血前起搏:右心耳和右室心尖起搏时左心室整体应变均小于窦性心律(P＜0.05).右室心尖起搏时后间隔节段峰值应变均小于右心耳起搏和窦性心律(P＜0.05);右心耳起搏时前间隔心尖及中间节段应变达峰时间均较右室心尖起搏延后(P＜0.05);左室18节段应变达峰时间标准差在窦性心律、右心耳起搏和右室心尖起搏模式下呈递增趋势(P＜0.05).②急性心肌缺血后起搏:右心耳和右室心尖起搏时左心室整体应变小于窦性心律(P＜0.05),右室心尖起搏时后间隔中间及基底节段峰值应变均小于右心耳起搏和窦性心律(P＜0.05);右心耳起搏时后间隔中间及基底节段应变达峰时间均较右室心尖起搏和窦性心律延后(P＜0.05);左室应变达峰时间标准差在窦性心律、右心耳起搏和右室心尖起搏间差异均无统计学意义(P＞0.05).③同一切面节段峰值应变在不同研究者间r=0.810,P＜0.001;研究者自身r=0.837,P＜0.001.结论 急性心肌缺血前后右心耳起搏及右室心尖起搏均未能使左心室心肌力学恢复至正常实性心律的有效和同步状态.
目的 採用超聲斑點追蹤成像技術評價急性心肌缺血前後右心耳起搏與右室心尖起搏模式下左心室心肌力學狀態.方法 結扎冠狀動脈左前降支建立急性心肌缺血比格犬模型.穫取14隻開胸犬急性心肌缺血前後竇性心律及兩種起搏狀態的標準左心室長軸切麵;分彆測量和計算左心室整體長軸應變及18節段長軸峰值應變、應變達峰時間、應變達峰時間標準差;進行不同研究者間和研究者自身重複性相關分析.結果 ①急性心肌缺血前起搏:右心耳和右室心尖起搏時左心室整體應變均小于竇性心律(P＜0.05).右室心尖起搏時後間隔節段峰值應變均小于右心耳起搏和竇性心律(P＜0.05);右心耳起搏時前間隔心尖及中間節段應變達峰時間均較右室心尖起搏延後(P＜0.05);左室18節段應變達峰時間標準差在竇性心律、右心耳起搏和右室心尖起搏模式下呈遞增趨勢(P＜0.05).②急性心肌缺血後起搏:右心耳和右室心尖起搏時左心室整體應變小于竇性心律(P＜0.05),右室心尖起搏時後間隔中間及基底節段峰值應變均小于右心耳起搏和竇性心律(P＜0.05);右心耳起搏時後間隔中間及基底節段應變達峰時間均較右室心尖起搏和竇性心律延後(P＜0.05);左室應變達峰時間標準差在竇性心律、右心耳起搏和右室心尖起搏間差異均無統計學意義(P＞0.05).③同一切麵節段峰值應變在不同研究者間r=0.810,P＜0.001;研究者自身r=0.837,P＜0.001.結論 急性心肌缺血前後右心耳起搏及右室心尖起搏均未能使左心室心肌力學恢複至正常實性心律的有效和同步狀態.
목적 채용초성반점추종성상기술평개급성심기결혈전후우심이기박여우실심첨기박모식하좌심실심기역학상태.방법 결찰관상동맥좌전강지건립급성심기결혈비격견모형.획취14지개흉견급성심기결혈전후두성심률급량충기박상태적표준좌심실장축절면;분별측량화계산좌심실정체장축응변급18절단장축봉치응변、응변체봉시간、응변체봉시간표준차;진행불동연구자간화연구자자신중복성상관분석.결과 ①급성심기결혈전기박:우심이화우실심첨기박시좌심실정체응변균소우두성심률(P＜0.05).우실심첨기박시후간격절단봉치응변균소우우심이기박화두성심률(P＜0.05);우심이기박시전간격심첨급중간절단응변체봉시간균교우실심첨기박연후(P＜0.05);좌실18절단응변체봉시간표준차재두성심률、우심이기박화우실심첨기박모식하정체증추세(P＜0.05).②급성심기결혈후기박:우심이화우실심첨기박시좌심실정체응변소우두성심률(P＜0.05),우실심첨기박시후간격중간급기저절단봉치응변균소우우심이기박화두성심률(P＜0.05);우심이기박시후간격중간급기저절단응변체봉시간균교우실심첨기박화두성심률연후(P＜0.05);좌실응변체봉시간표준차재두성심률、우심이기박화우실심첨기박간차이균무통계학의의(P＞0.05).③동일절면절단봉치응변재불동연구자간r=0.810,P＜0.001;연구자자신r=0.837,P＜0.001.결론 급성심기결혈전후우심이기박급우실심첨기박균미능사좌심실심기역학회복지정상실성심률적유효화동보상태.
Objective To evaluate the myocardial mechanical pattern of left ventricle(LV)before and after acute myocardial ischemia during right atrial appendage pacing(RAA-P)and right ventricular apical pacing(RVA-P)using ultrasonic speckle tracking imaging(STI).Methods Left anterior descending coronary artery was ligated for acute myocardial ischemia in open-chest beagle canine models(n=14).The two dimensional apical views in LV were acquired during normal sinus rhythm(NSR),RAA-P and RVA-P
before and after acute myocardial ischemia.The longitudinal global strain(ε),18 segmenal peak strain,time to peak longitudinal strain(Te)and 18 segmental time to peak longitudinal strain-standard deviation(Tε-18SD) of LV were measured and calculated.Reproducibility correlation analysis was performed.Results ①Before acute myocardial ischemia:the global ε of LV during RAA-P and RVA-P were lower than that during NSR(P＜0.05).The peak ε at interventricular septum during RVA-P was lower than that during NSR and RAA-P(P＜0.05);Tε of anterior septum at apical and middle level during RVA-P was shortened than that during RAA-P(P＜0.05).Tε-18SD of LV increase progressively between NSR,RAA-P and RVA-P(P＜0.05).②After acute myocardial ischemia:the global ε of LV during RAA-P and RVA-P were lower than that during ischemical sinus rhythm(ISCH-SR)(P＜0.05).The peak ε of interventricular septum at middle and basal level during RVA-P was lower than that during ISCH-SR and RAA-P(P＜0.05).The Tε of interventrieular septum at middle and basal level during ISCH-SR and RVA-P was shortened than that during RAA-P(P＜0.05).There was no significant difference of LV Tε-18SD during ISCH-SR,RAA-P and RVA-P.③There was a reasonable reproducibility for the measurement of LV segmental peak ε for both interobserver(r=0.810,P＜:0.001)and intraobserver(r=0.837,P＜0.001).Conclusions Both RAA-P and RVA-P couldn't achieve a normal LV mechanical pattern before and after myocardial ischemia.
