斑点追踪技术结合实时心肌声学造影研究犬冠脉阻断后左室收缩功能及微循环状况  

Left Ventricular Systolic Function and Microcirculation Perfusion with Coronary Artery Occluded in Dogs using Speckle Tracking Imaging Technology and Real-time Myocardial Contrast Echocardiography

作　　者：白洋[1] 杨军[1] 郭亚军[2] 喻晓娜[2] 王欣[2] 韩舒[1] 

机构地区：[1]中国医科大学附属第一临床学院心功能科,沈阳市110001 [2]中国医科大学附属盛京医院超声科

出　　处：《中国超声医学杂志》2010年第10期868-871,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.20092134)

摘　　要：目的应用斑点追踪技术(STI)及实时心肌声学造影(RT-MCE),研究犬冠脉阻断后,左室心肌收缩能力和微循环状况的变化及相互关系,探寻识别存活心肌的新方法。方法 15只犬左冠脉前降支(LAD)阻断前15min,阻断后15min、1h、2h、3h进行STI及RT-MCE检查,采用TTC染色确定梗死、缺血及正常节段。结果阻断后15min,梗死及缺血节段收缩期峰值径向应变(SR_(peak))显著减低;随时间延续,梗死节段SR_(peak)持续下降,缺血节段SR_(peak)缓慢升高(P<0.01)。缺血区峰值视频密度(A)及心肌血流量(A×β)随时间增高,与SR_(peak)正相关;梗死区A及A×β保持低水平(P<0.01)。阻断3 h后,SR_(peak)>9.2%诊断存活心肌的敏感性为79%,特异性为80%。结论 STI可预测心肌缺血程度,并在一定程度上识别存活心肌。Objective To study the changes of left ventricular systolic function and microcirculation perfusion coronary artery occluded in dogs as well as the relationship between them using speckle tracking imaging （STI）and real-time myocardial contrast echocardiography （RT-MCE）to explore a new method to identify viable myocardiurn. Methods Left anterior descending coronary artery （LAD）of adult dogs（n = 15）was occluded for at lest 3 hours and STI as well as RT-MCE was performed in baseline（15 min before occluded）, 15 min and 1,2,3 hours after occluded. TTC staining was used to identify the infracted,isehemic and normal segments. Results 15min After occluded, the peak systolic radial strain （SRpcak）Of infarcted and isehemic area significantly reduced. The SRpeak of infracted area declined continually over time, while that of ischemie area slowly increased （P〈0.01）. The peak video intensity （A） and myocardial blood flow （A ×β）of ischemic area increased with time, which were positively correlated to the increase of SRpeak. The A and A ×β of infarcted area kept low value（P〈0.01）. 3 hours after occluded, SRpeak 〉9.2 %. Sensitivity and specificity to identify viable myocardium were 79% and 80% respectively. Conclusions Severity of myocardial ischemia can be speculated by SRpeak. SRpeak is of certain diagnostic value to identify viable myocardium.

关 键 词：斑点追踪技术 实时心肌声学造影 存活心肌 

分 类 号：R542.22[医药卫生—心血管疾病]