犬左室急性心肌缺血状态下右心功能的超声应变率研究  

Strain Rate Imaging Evaluating Right Heart Function of Acute Left Ventricular Myocardial Ischemia in Dogs

作　　者：穆玉明[1] 李江涛[1] 王春梅[1] 唐琪[1] 古丽齐满.霍加阿不都拉 

机构地区：[1]新疆医科大学第一附属医院心脏超声诊断科,乌鲁木齐市830000

出　　处：《中国超声医学杂志》2008年第3期200-202,共3页Chinese Journal of Ultrasound in Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(No.200421101)

摘　　要：目的应用应变率显像(SRI)技术研究犬左室急性心肌缺血状态下对右心功能的影响。方法10只犬,分别于冠状动脉左前降支结扎前、后10 min采集心尖四腔观图像,测量缺血前后右室壁、右房壁及三尖瓣环的收缩期应变率(SSR)、舒张早期应变率(ESR)、舒张晚期应变率(ASR)、右室射血分数(RVEF)和用导管法测肺动脉收缩压(PASP)。结果左室局部急性心肌缺血后,PASP增加(P<0.05),RVEF降低(P<0.05),右室壁和三尖瓣环的SSR、ESR及ASR降低(P<0.05),右房壁SSR和ASR增加(P<0.05)。心肌缺血前,右室壁SR与右房壁SR无明显相关性,缺血后两者呈负相关。心肌缺血前后RVEF值与右室壁及三尖瓣环的SSR峰值均呈正相关。缺血后PASP分别与右室壁SSR和RVEF呈负相关。结论左室前壁急性心肌缺血可引起右室壁舒缩功能减退和PASP增加,右房壁舒缩功能代偿性增加,三者之间有一定的相关性。Objective To study the changes of right heart function in dogs using strain rate imaging （SRI）after the left ventricular acute myocardial ischemia. Methods Ten dogs were subjected to LAD coronary artery occlusion for acute ischemia. Peak strain rate of systole （SSR）, early diastole （ESR）, and late diastole （ASR） in the right heart myocardial wall, the tricuspid annulus and right ventricular ejecting fraction （RVEF） were measured and catheterized systolic pressure of pulmonary artery systolic pressure （PASP） were measured at pre- and post- LAD ligation, respectively. Results PASP were increased （P〈0. 05）, RVEF were decreased （P〈0. 05）, SSR, ASR, ESRof the right ventricle and the tricuspid annulus were significantly decreased （P〈0. 05） after myocardium ischemia. The SSR and ESRof the right atrial wall were increased （P〈0. 05） RVEF had no positive correlation with SsRof the right ventricle and the tricuspid annulus at pre-ischemia. RVEF did have positive correlation with SSR of the right ventricle and the tricuspid annulus at post-ischemia. SSR and ASR of the right ventricle positively correlated with SSR and ASR of the right atrial wall and PASP negatively correlated with SSR of the right ventricle and RVEF, respectively. Conclusions Acute myocardial ischemia of LV may decrease the right ventricular systolic/diastolic function and increased PASP. Right atrial wall will be compensatory increased in systolic and diastolic function. There are a certain degree of correlation among strain rate of left ventricular and right ventricular PASP.

关 键 词：急性心肌缺血 超声应变率显像 右心功能 

分 类 号：R541.4[医药卫生—心血管疾病]