实时三维超声定量评价犬急性右室心肌缺血时心室间相互作用  

Real-Time Three-dimensional Echocardiographic Quantitative Assessment of Ventricular Interaction of Canines in Acute Right Ventricular Myocardial Ischemia

作　　者：张立敏[1] 孙晖[2] 任卫东[1] 马春燕[1] 陈昕[1] 

机构地区：[1]中国医科大学附属一院心血管检查科,沈阳市110001 [2]吉林大学第四医院电诊科

出　　处：《中国超声医学杂志》2008年第3期203-206,共4页Chinese Journal of Ultrasound in Medicine

基　　金：辽宁省自然科学基金资助项目(No.20062095)

摘　　要：目的探讨实时三维超声(RT-3DE)定量评价犬急性右室心肌缺血时心室间相互作用的价值。方法18只犬,暴露心脏,于右冠状动脉阻断前后分别进行如下检测:测量右室舒张末压(RVEDP)、收缩末压(RVESP);左室舒张末压(LVEDP)、收缩末压(LVESP);应用RT-3DE测量右室舒张末容积(RVEDV)、收缩末容积(RVESV);左室舒张末容积(LVEDV)、收缩末容积(LVESV),计算两心室每搏量(SV)、射血分数(EF)及后间隔的节段射血分数(rEF)。犬右冠状动脉阻断前为正常对照组;阻断后为实验组。结果阻断右冠状动脉不影响室间隔血供。实验组:RVEDP显著升高(P<0.01),RVESP降低(P<0.05),而LVESP显著降低(P<0.001);RVEDV及RVESV均显著增加(P<0.05;P<0.01),LVEDV显著减小(P<0.05);RVSV、RVEF及LVSV均减低(P<0.01;P<0.001;P<0.05)。实验组后间隔的rEF较对照组显著降低(P<0.05)。结论RT-3DE能无创定量评价犬急性右室心肌缺血后心室间相互作用、反映血流动力学变化、定量评价右室和左室收缩功能及心肌节段收缩功能。Objective To discuss the value of real-time three-dimensional echocardiography （RT-3DE） in noninvasive evaluating ventricular interaction in acute right ventricular myocardial ischemia. Methods Eightteen canines were used in this study. Right coronary artery ischemia was induced by occlusion at the proximal segment. Before RCA ischemia, the canine was definited as the normal control group and after ischemia definited as the experiment group. RVEDP, RVESP, MABP, LVEDP and LVESP were obtained from each ventricle at baseline and after 5 minutes of RCA occlusion. RT-3DE protocol was before and during ischemia ： RVEDV, LVEDV, RVESV, LVESV were measured using RT-3DE with 3DQ advanced standard commercial software （Philips iE-33） . At the meantime,SV,EF and rEF of posterior interventricular septum were calculated. Results Blocking RCA did not effect the blood supply of the interventricular septum tissue. In IRCA group.. RVEDP was increased （P〈0. 01）, RVESP and LVESP were decreased significantly （P〈0. 05, P〈0. 001. respectively）. Compared with NC group ; RVEDV and RVESV were increased obviously （P 〈 0. 05 ）, but LVEDV diminished obviously. Compared with the NC group. RVSV, RVEF and LVSV were also decreased significantly in IRCA group （P〈0. 05） Conclusions RT-3DE can noninvasively quantify ventricular interaction, which reflects haemodynamic variance, and can quantify ventricular function and regional contractile function in acute right ventricular myocardial ischemia.

关 键 词：实时三维超声心动图 右室心肌缺血 心室容积 心室间相互作用 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]