分层二维斑点追踪显像评价射频消融肾交感神经对心力衰竭犬左室收缩功能的影响  

Evaluation of left ventricular systolic function after renal sympathetic denervation in beagles with heart failure by layer-specific two-dimensional speckle tracking imaging

作　　者：贾妍[1] 胡伟[1] 赵志玉[1] 宋宏宁[1] 陈金玲[1] 周青[1] 郭瑞强[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》2017年第7期623-627,共5页Chinese Journal of Ultrasonography

摘　　要：目的应用分层二维斑点追踪显像技术评价。肾动脉交感神经经导管射频消融对心力衰竭犬左室收缩功能的影响。方法将23只比格犬随机分为3组：对照组（8只）、未消融组（8只）和消融组（7只）。对照组犬装起搏器，但不开启；未消融组装好起搏器后开始快速右室起搏3周；消融组先对双侧肾交感神经消融，同时植入起搏器，开启快速右室起搏3周。分别获取各组二尖瓣、乳头肌和心尖部水平的左室短轴观，以及心尖四腔、二腔及心尖左室长轴观图像，应用分层二维斑点追踪技术测量各组的左室内膜下、中层、外膜下心肌的纵向和环向应变参数，并比较左室整体纵向、环向及径向应变峰值。结果3周后，未消融组犬和消融组犬左室收缩功能及舒张功能较正常对照组均有减低，但消融组犬左室射血分数高于未消融组（P〈0．05）。对照组、未消融组、消融组的纵向应变和环向应变峰值均为心内膜下心肌〉中层心肌〉心外膜下心肌，呈递减趋势。与对照组相比，未消融组和消融组整体径向应变、环向应变及径向应变均减低（均P〈0．05）、与未消融组相比，消融组的心内膜下、中层心肌的纵向峰值应变增高，心内膜下心肌的环向峰值应变增高，差异有统计学意义（P〈0．05）。结论心力衰竭犬左室各层心肌收缩功能减低，分层二维斑点追踪显像技术能够准确评价心力衰竭犬左室收缩功能的变化。肾交感神经消融可以改善心力衰竭犬左室心肌的收缩功能。Objective To assess the left ventricular systolic function after renal sympathetic denervation（RSD） in beagles with heart failure by layer-specific two-dimensional speckle tracking imaging. Methods Twenty-three beagles were randomly divided into control group （8 dogs）, URSD group （8 dogs） and RSD group （7 dogs）. Control group was implanted with pacemakers without pacing, URSD group was implanted with pacemakers and underwent 3 weeks of rapid right ventricular pacing, and RSD group underwent catheter-based RSD bilaterally and was simultaneously implanted with pacemakers. All standard measurements were obtained from the left ventricular short-axis views at the levels of mitral annulus, papillary muscle and apex, and apical four-chamber, two-chamber, and long-axis views. The peak systolic longitudinal strain and circumferential strain of each layer of the left ventricle were measured by layerspecific two-dimensional speckle tracking imaging. Results After 3 weeks, all of the dogs in both the URSD and RSD groups showed lower left ventricular diastolic and systolic function compared with those in the control group, however, the dogs in the RSD group had a higher LV ejection fraction （LVEF） than the dogs in the URSD group （ P 〈0.05）. Compared with the control group, the global longitudinal strain, circumferential strain and radial strain all decreased significantly in URSD and RSD groups. The longitudinal strain of endo- and mid-cardium and the circumferential strain in endo-cardium were significantly higher in RSD group than those in URSD group（ P 〈0.05）. Conclusions Myocardial systolic function is impaired in dogs with heart failure, layer-specific two-dimensional speckle tracking imaging can provide effective tools to assess the left ventricular systolic function. Renal sympathetic denervation can improve the myocardial systolic function in dogs with heart failure.

关 键 词：超声心动描记术 肾交感神经 导管消融术 心室功能 左 分层斑点追踪显像 

分 类 号：R540.45[医药卫生—心血管疾病] R541.6[医药卫生—内科学]