三平面组织多普勒成像技术对心衰犬收缩功能的研究  

Triplane Tissue Doppler Imaging Evaluation of Left Ventricular Systolic Function in Canine Heart failure Model

作　　者：吴伟春[1] 王浩[1] 袁卫民[2] 唐跃[2] 罗富良[2] 李悦[2] 王红月[3] 江勇[1] 

机构地区：[1]北京协和医学院中国医学科学院心血管病研究所北京阜外心血管病医院超声科,北京市100037 [2]北京协和医学院中国医学科学院心血管病研究所北京阜外心血管病医院动物实验中心,北京市100037 [3]北京协和医学院中国医学科学院心血管病研究所北京阜外心血管病医院病理科,北京市100037

出　　处：《中国超声医学杂志》2008年第6期484-488,共5页Chinese Journal of Ultrasound in Medicine

基　　金：国家教委高校博士点基金(No.20030023030)

摘　　要：目的探讨三平面组织多普勒(TTDI)新技术对快速起搏致心衰犬模型的左室收缩功能评价价值和变化特点。方法将8只健康杂种犬进行快速非同步起搏造成心功能减低,并应用TTDI测量全过程二尖瓣环6个部位的收缩期峰值速度(S)、平均峰值速度(Sm)以及采用双平面Simpson法测量EF值及左室容积,并同时行心导管测量主动脉、左室压力及采用左室造影法测量EF值,并将造影结果与TTDI指标进行比较。结果快速起搏2周左右,全部犬的心功能均发生减低。病理示心脏扩大,部分有乳头肌水肿,二尖瓣叶损害及少量心包积液;心导管测量左室舒张末压显著上升,左室造影EF值降低;常规超声指标示左房、室内径增加,左室容积增加;TTDI能够同时显示二尖瓣环6个部位的曲线运动变化,并依次采用黄色、蓝色、红色、绿色、橘色、粉红色表示。基础状态下,6个瓣环的S波表现为有规律的由高到低的顺序排列;随着起搏天数的增加,S波逐渐减低,并且TTDI曲线开始杂乱,失去规律性;起搏1周后,S波显著降低,并出现收缩后收缩。左室造影EF与TTDI二尖瓣环6个部位的S波均有相关性,Sm的r=0.745,P<0.01;其中后室间隔和下壁处的S波与造影EF值相关性最好,r值分别为0.758和0.775,P<0.01。结论三平面组织多普勒能够反映快速起搏致心衰过程中的左室收缩功能变化,并能同时直观反映二尖瓣环各个部位的变化特点。Objective To evaluate left ventricular systolic function in a canine mode with heart failure using a novel technology of triplane tissue Doppler imaging （TTDI） . Methods Eight healthy mongrel dogs of either gender were used to induce left ventricular （LV） dysfunction with rapid right ventricular pacing intervension. TTDI peak myocardial systolic velocities （S） were acquired at the mitral annular sites from different planes （two sites in each plane, totally six sites） and to measure their mean systolic velocity （Sm） at baseline, during pacing and at the end point. Meanwhile, Ejection fraction （EF）, LV end diastolic volume were measured using bi-plane Simpson＇s rule; aortic artery, LV pressures and EF were also measured using cardiac catheterization and left ventriculography respectively to serve as the golden standard for evaluation of the value on TTDI. Results After about 2 weeks rapid pacing, the heart function of all dogs were impaired. Postmortem examination showed dilated heart chamber, papillary muscle edema, damage of mitral valve and mild pericardial effusion. There were significant increases in LV and left atrial （LA） diameters, LV volume and LV end-diastolic pressure ~ but decrease of EF value at the end point compared to those at baseline. TTDI could demonstrate six mitral annular site motions spontaneously ： Yellow, blue, red, green,orange and pink by turns represented the motion of every six mitral annular sites. S waves were regular arranged at baseline but were decreased with rapid pacing and post systolic shortening progressively appeared. Every S wave at the six mitral annular sites was correlated with EF measured by left ventriculography and there was a good correlation between Sm and EF （r = 0. 745, P〈0.01 ） whereas peak S at posterior interventricular septum and inferior mitral annular wall correlated well with EF on left ventriculography （r=0. 758 and 0. 775, P〈0.01 respectively）. Conclusions TTDI provides a new method to evaluate cardiac systolic f

关 键 词：三平面组织多普勒 左心功能 快速起搏 犬 

分 类 号：R541.6[医药卫生—心血管疾病]