QTVI结合小剂量多巴酚丁胺负荷试验检测存活心肌的评估  

Assessing myocardial viability of acute myocardial infarction with quantitative tissue velocity imaging and low dose dobutamine stress echocardiography

作　　者：李红玲[1] 周晓东[1] 张海滨[1] 张军[1] 李军[1] 朱霆[1] 贺建国[1] 

机构地区：[1]第四军医大学西京医院超声科,陕西西安710032

出　　处：《心脏杂志》2005年第6期555-558,共4页Chinese Heart Journal

摘　　要：目的:应用定量组织多普勒速度成像(QTVI)结合小剂量多巴酚丁胺负荷试验(LDDS)评价存活心肌。方法:结扎犬LCX建立急性心肌梗死模型,分别于LDDS前、后记录心尖3个切面组织多普勒图像,根据QTVI在负荷前后变化特征确定存活心肌,并与三苯四氮唑溶液(TTC)染色及心肌声学造影对照。结果:LDDS前,存活心肌与非存活心肌节段间收缩期峰值速度(Vs)和收缩期最大位移(D s)比较无显著性差异(P>0.05),LDDS后与LDDS前相比,存活心肌节段的室壁Vs及D s显著升高(P<0.01),无存活心肌室壁Vs及D s变化无统计学意义(P>0.05),LDDS中以负荷前后收缩期速度变化差值(△Vs)>0.66 cm/s作为截断值判断存活心肌的敏感性83%,特异性87%,以负荷前后收缩期位移变化差值(△D s)>0.61 mm作为截断值判断存活心肌的敏感性为80%,特异性为89%。结论:应用QTVI与LDDS结合,可以检测梗死区的存活心肌。AIM ： To explore the value of combining quantitative tissue velocity imaging （QTVI） with lowdose dobutamine stress （LDDS） in evaluating myocardial viability. METHODS ： The acute myocardial infarction （AMI） models were set up by ligating the LCX of dogs. After collecting the imaging information from the apical four chamber, long axis and two chamber views by using QTVI, the systolic velocity （Vs） of left ventricular（LV） wall was analyzed by tissue velocity and the systolic displacement（Ds） of LV wall was analyzed by tissue tracking（TT）. The position and the range of the myocardial infarction areas were determined with TTC staining and myocardial contrast echocardiography. The surviving myocardium was determined by the change of QTVI which reflects the myocardial contractility reserve, and compared with TTC staining and myocardial contrast echocardiography. RESULTS： Before LDDS there was no significant difference of Vs and Ds between viable and unviable myocardium . The changes of Vs and Ds in the surviving myocardium segments were significant （ P 〈 0.01 ） , while no change was found in Vs and Ds in the segments of myocardium infarction（P 〉 0.05 ） after LDDS. When A Vs 〉 0.66 mm/s was used as a threshold to determine whether the myocardium survived or not, the sensitivity was 83% and the specificity was 87%. When ADs 〉0.61 mm was used as the standard, the sensitivity was 80% and specificity was 89%. CONCLUSION ： Combined with the LDDS, QTVI can forecast the surviving possibility of myocardia.

关 键 词：组织速度成像 组织追踪法 心肌梗塞 急性 多巴酚丁胺 

分 类 号：R542.2[医药卫生—心血管疾病]