CAJ | 학술논문

目的探讨犬缺血-再灌注模型中斑点追踪超声心动图检查存活心肌的价值.材料与方法健康犬14只,开胸后阻断左冠状动脉前降支构建心肌缺血-再灌注模型(缺血3h,再灌注1h),于再灌注1h 采集左心室中部切面短轴二维图像,处死犬后行氯化三苯基四氮唑(TTC)染色.随机测量84个节段收缩末期的径向应变和圆周应变,根据 TTC 染色结果,比较梗死面积≤50%及>50%节段的径向应变和圆周应变.结果与≤50%梗死面积或无梗死节段相比,梗死面积>50%的节段,其收缩末期径向应变和圆周应变减低(P<0.05).收缩末期径向应变≥9.72%,判定心肌存活的敏感度为77%,特异度为84%;圆周应变≤-4.92%,判定心肌存活的敏感度为90%,特异度为94%,两者判断心肌存活的优劣性差异无统计学意义(P>0.05),但圆周应变有更大的曲线下面积.结论二维应变超声心动图能够检测心肌功能障碍,评价心肌存活性;收缩末期径向应变与圆周应变均为可靠指标.
목적탐토견결혈-재관주모형중반점추종초성심동도검사존활심기적개치.재료여방법건강견14지,개흉후조단좌관상동맥전강지구건심기결혈-재관주모형(결혈3h,재관주1h),우재관주1h 채집좌심실중부절면단축이유도상,처사견후행록화삼분기사담서(TTC)염색.수궤측량84개절단수축말기적경향응변화원주응변,근거 TTC 염색결과,비교경사면적≤50%급>50%절단적경향응변화원주응변.결과여≤50%경사면적혹무경사절단상비,경사면적>50%적절단,기수축말기경향응변화원주응변감저(P<0.05).수축말기경향응변≥9.72%,판정심기존활적민감도위77%,특이도위84%;원주응변≤-4.92%,판정심기존활적민감도위90%,특이도위94%,량자판단심기존활적우렬성차이무통계학의의(P>0.05),단원주응변유경대적곡선하면적.결론이유응변초성심동도능구검측심기공능장애,평개심기존활성;수축말기경향응변여원주응변균위가고지표.
Purpose To investigate speckle tracking imaging (STI) in distinguishing viable myocardium from infarction in a dog ischemia-reperfusion model. Materials and Methods Fourteen healthy dogs underwent left anterior descending coronary artery occlusion for three hours followed by one hour reperfusion. Short-axis STI was performed in the mid-ventricle one hour post reperfusion. Triphenyl tetrazolium chloride (TTC) stain was used postsacrifice. Regional end-systolic radial and circumferential strain were measured using software in all 84 segments with areas of infarct in corresponding histological slices. Results The extent of infarct correlates with radial and circumferential strain. The larger infarct size, the smaller radial and circumferential strain. Segments with greater than 50% area of infarct had lower end-systolic radial and circumferential strain compared with areas with <50% or no infarct. End-systolic radial strain greater than 9.72% had 77% sensitivity and 84%specificity for detecting viable area greater than 50%. End-systolic circumferential strain less than -4.92% had 90% sensitivity and 94% specificity for detecting viable area greater than 50%. There was no significant difference between radial and circumferential strain for myocardial viability assessment. However, circumferential strain had a greater area under the ROC curve. Conclusion In addition to detecting myocardial dysfunction, strain measurements are helpful in the assessment of myocardial viability. End-systolic radial and circumferential strain may be reliable indicators.