CAJ | 학술논문

目的应用超声三维斑点追踪技术研究快速起搏诱发心力衰竭比格犬心脏再同步化治疗(CRT)前后左心室扭转运动的变化和预测CRT疗效的扭转参数.方法 22只成年比格犬以右心室快速起搏3周诱发心力衰竭,其中15只接受CRT治疗,7只作为对照.在基线、快速起搏3周和CRT 2周时采集经胸左心室全容积图像,应用Tom-Tec 4D LV Analysis 3.0软件分析,自动计算左心室心尖部和心底部旋转角度峰值(AP-Prot、MV-Prot)、左心室扭转角度峰值(Ptw)、左心室扭转力矩峰值(Ptor)等;探索预测心力衰竭比格犬CRT疗效的左心室扭转参数.结果经CRT治疗2周,心力衰竭比格犬左室射血分数(LVEF)、左室收缩末期容积(LVESV)明显改善(P均＜0.05).以LVESV缩小≥1 5％作为CRT治疗有效的标准将接受治疗的比格犬分为有效组(9只)与无效组(6只),两组在接受CRT治疗前Ptw[(7.43±0.61)°对(6.06±0.89)°,P＜0.01]与Ptor[(1.43±0.45)°/cm对(0.67±0.36)°/cm,P=0.04]差异存在统计学意义,且Ptw与Ptor对CRT疗效具有预测价值,敏感性分别为89％和85％,特异性分别为83％和84％.结论超声三维斑点追踪技术能够用于评价心力衰竭比格犬CRT前后左室扭转运动;左室整体扭转功能对CRT疗效具有预测价值.
목적 응용초성삼유반점추종기술연구쾌속기박유발심력쇠갈비격견심장재동보화치료(CRT)전후좌심실뉴전운동적변화화예측CRT료효적뉴전삼수.방법 22지성년비격견이우심실쾌속기박3주유발심력쇠갈,기중15지접수CRT치료,7지작위대조.재기선、쾌속기박3주화CRT 2주시채집경흉좌심실전용적도상,응용Tom-Tec 4D LV Analysis 3.0연건분석,자동계산좌심실심첨부화심저부선전각도봉치(AP-Prot、MV-Prot)、좌심실뉴전각도봉치(Ptw)、좌심실뉴전력구봉치(Ptor)등;탐색예측심력쇠갈비격견CRT료효적좌심실뉴전삼수.결과 경CRT치료2주,심력쇠갈비격견좌실사혈분수(LVEF)、좌실수축말기용적(LVESV)명현개선(P균＜0.05).이LVESV축소≥1 5％작위CRT치료유효적표준장접수치료적비격견분위유효조(9지)여무효조(6지),량조재접수CRT치료전Ptw[(7.43±0.61)°대(6.06±0.89)°,P＜0.01]여Ptor[(1.43±0.45)°/cm대(0.67±0.36)°/cm,P=0.04]차이존재통계학의의,차Ptw여Ptor대CRT료효구유예측개치,민감성분별위89％화85％,특이성분별위83％화84％.결론 초성삼유반점추종기술능구용우평개심력쇠갈비격견CRT전후좌실뉴전운동;좌실정체뉴전공능대CRT료효구유예측개치.
Objective To assess left ventricular (LV) twist in a rapid pacing induced heart failure canine model undergoing cardiac resynchronization therapy (CRT) by three-dimensional speckle tracking imaging (3D-STI).Methods Rapid right ventricular pacing (RVP) was utilized in 22 adult beagle dogs for 3 weeks to induce heart failure.Then 15 dogs received CRT for 2 weeks and others were treated as control.Apical full-volume acquisition of the LV was obtained in conscious animals at baseline,the end of 3-week RVP and the end of 2-week CRT.Peak LV apical (AP-Prot) and basal rotation (MV-Prot) along with peak twist (Ptw) and torsion (Ptor) were automatically calculated by TomTec 4D LV Analysis 3.0 software to identify the ideal parameter in predicting treatment response of CRT.Results After 2 weeks of CRT,LV ejection fraction(LVEF) increased and LV end-systolic volume(LVESV) decreased significantly in dogs with heart failure.CRT treatment response,defined as improvement of LVESV≥15％,was observed in 9 dogs.Significant difference was found in Ptw [(7.43 ± 0.61) vs (6.06 ± 0.89)°,P ＜0.05] and Ptor [(1.43 ± 0.45) vs (0.67 ± 0.36)°/cm,P ＜0.05] between responders and nonresponders.Ptw and Ptor predicted CRT response with satisfying sensitivity as 89％ and 85％,specificity as 83％ and 84％,respectively.Conclusions Peak twist and torsion evaluated by 3D-STI represented overall LV twist and demonstrated potential prediction value for treatment response of CRT.