多巴酚丁胺负荷试验结合斑点追踪成像技术识别心肌梗死犬存活心肌的实验研究  

Detecting of viable myocardium by dobutamine stress echocardiography and speckle tracking imaging in myocardial infarction models of dogs

作　　者：丁尚伟[1] 黄晓宇[1] 吴文谦[1] 张艳容[1] 张培歌 武彧[1] 于艾嘉 谢明星[1] 吕清[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科湖北省分子影像重点实验室,武汉 430022

出　　处：《临床心血管病杂志》2014年第2期166-169,共4页Journal of Clinical Cardiology

基　　金：国家自然科学基金青年科学基金项目(No:81000616)

摘　　要：目的:应用多巴酚丁胺负荷试验,结合斑点追踪成像(STI)技术,识别心肌梗死犬危险区的存活心肌。方法:于实验犬左冠状动脉(冠脉)前降支分出第1对角支后约1cm处结扎,建立心肌梗死犬模型。结扎3h后行多巴酚丁胺负荷试验,剂量组分别为0、5、10、20、30和40μg·kg-1·min-1,每个剂量组持续推注3min,分别采集心尖四腔、心尖两腔、心尖三腔切面图像。负荷试验结束后处死犬,游离心脏,行Evans Blue和TTC双染色。STI定量分析0μg·kg-1·min-1时危险区梗死心肌的节段数,同时结合心肌染色结果计算其中的存活心肌节段数,然后分析负荷试验不同剂量组条件下的心肌运动,判断其识别存活心肌的准确率。结果:120只犬成功建立心肌梗死模型。结扎3h后,0μg·kg-1·min-1时STI定量分析梗死心肌节段数61个,Evans Blue和TTC双染色显示其中的存活心肌节段数42个,其收缩期长轴应变率峰值(SrLP)为(0.48±0.24);40μg·kg-1·min-1条件下STI识别出存活心肌节段数39/42个,准确率92.9%,其SrLP明显改善(-0.65±0.45),与0μg·kg-1·min-1相比,差异有统计学意义(P<0.01)。结论:多巴酚丁胺负荷试验结合STI技术能准确识别危险区的存活心肌。Objective：To combine dobutamine stress echocardiography（DSE）and speckle tracking imaging（STI）for detecting viable myocardium.Method：The myocardial infarction models of dogs were performed by ligating the left anterior descending（LAD）.Three hours later,the images of apical 4-chamber,2-chamber and left ventricular long-axis views were collected during DSE（0,5,10,20,30,40μg·kg-1·min-1;each group 3min）,then the dogs were killed and their hearts were dyed by Evans Blue and TTC.Firstly the number of viable myocardium segments was know from STI（0μg·kg-1·min-1,DSE）and Evans Blue and TTC staining,then the images of DSE in each group（5,10,20,30,40g·kg-1·min-1）were analyzed by STI and to indentify the true viable myocardium,so the accuracy rate of detecting viable myocardium was clear by dobutamine stress echocardiography and speckle tracking imaging.Result：Forty-two segments of viable myocardium were detected by STI（0g·kg-1·min-1）and heart staining in 18successful models,with 39/42detected by STI and DSE（5,10,20, 30,40g·kg-1·min-1）.The accuracy rate was 92.9%.Conclusion：It is useful to detecte viable myocardium by combining DSE and STI.

关 键 词：存活心肌 斑点追踪 多巴酚丁胺负荷试验 

分 类 号：R542.2[医药卫生—心血管疾病]