二维斑点追踪成像评价射频消融肾交感神经对心脏同步性的影响  

Evaluation of the synchrony of heart after catheter-based renal denervation by two dimensional strain imaging

作　　者：胡伟[1] 郭瑞强[1] 于胜波[1] 肖金平[1] 王徐乐[1] 代子玄[1] 赵庆彦[1] 

机构地区：[1]武汉大学人民医院超声影像科,430060

出　　处：《中华超声影像学杂志》2014年第6期527-530,共4页Chinese Journal of Ultrasonography

摘　　要：目的应用超声二维斑点追踪显像（speckle tracking imaging，STI）技术检测肾动脉交感神经经导管射频消融后对心脏的影响。方法对20只犬的肾交感神经进行射频消融，分别于消融前和消融6周后观察肾交感神经消融犬的血压变化及心脏指标变化。采集犬心尖两腔观、三腔观、四腔观的清晰图像，用Qlab软件测量各切面观心尖水平、二尖瓣水平和乳头肌水平16节段自QRS起点至收缩期峰值应变率达峰时间，及舒张期峰值应变率达峰时间；用Qlab软件分析左房前壁、下壁、间隔及侧壁基底段、中间段及心底段12节段同步性指标，包括：左房储蓄功能期峰值应变率达峰时间及左房主动收缩期峰值应变率达峰时间。结果与消融前相比，消融后收缩压和舒张压均无明显变化（P〉0．05）。消融后犬R—R间期呈延长趋势，但差异无统计学意义，左室16节段收缩期及舒张期峰值应变率达峰时间也呈延长趋势，但差异无统计学意义，其标准差也无明显差异（P〉0．05）。左房12节段储备功能期及辅泵功能期峰值应变率达峰时间也呈延长趋势，但差异无统计学意义，其标准差也无明显差异（P〉0．05）。消融前后心脏各腔室大小未见明显变化（P〉0．05）。结论消融犬。肾交感神经后收缩压及舒张压均无明显降低，心脏R-R间期及左房、左室应变率达峰时间呈延长趋势，左房及左室同步性无影响。Objective To evaluate the synchrony of heart after catheter-based renal denervation by two dimensional speckle tracking imaging.Methods Each renal sympathetic nerve of 20 dogs were ablated, and the index of heart and blood pressure were detected 6 weeks later.Standard 2D images were acquired in the 2-,3- and 4- apical views. The times from QRS onset to peak-systolic strain rate and to peak-diastolic strain rate were measured for the longitudinal 16-segments in Qlab software,and the standard deviation were calculated.The time to peak longitudinal strain rate and time to peak contraction strain rate of left atrium were measured for each segment contained septal, latera, anterior and posterior in the level of the basal segments, middle sections and apical in Qlab software, and the standard deviation were calculated.Parameters were compared among the before and after of the ablation. Results The systolic pressure and diastolic pressure had no changes after the ablation of renal sympathetic nerve （P 〉0.05）. The R-R showed a increasing trend,but no significant differences（ P 〉0.05）.The peak time of LV systolic and diastolic strain rate had a extended trendency too,but no differences（ P 〉0.05）,and standard deviations of the peak times had no significant differences（ P 〉0.05）.The peak time of LA longitudinal strain rate and contraction strain rate had a extended trendency,but no obvious change （ P 〉0.05）,and the standard deviations of the peak times had no significant differences （P 〉0.05）.The size of the heart cavity had no differences（ P 〉0.05）. Conclusions The systolic pressure and diastolic pressure have no changes after the ablation of renal sympathetic nerve,and the synchrony parameters of LV and LA have no significant differences, demonstrate that the synchrony of heart is not affected by the renal sympathetic denervation.

关 键 词：超声心动描记术 肾交感神经 导管消融术 心脏同步性 斑点追踪显像 

分 类 号：R544.1[医药卫生—心血管疾病]