超声负荷分层应变评价兔心肌缺血ATP药物后适应模型的心肌储备效应  

Evaluation of mycardial reserve effect in pharmacological postconditioning rabbits′ model by stress echocardiograpy and multilayer strain

作　　者：吴新宇 姜中慧 李克婷 赵鹏[1] 杨宏宇 陈艳杰 谢艳秋 田家玮[1] 任敏 Wu Xinyu;Jiang Zhonghui;Li Keting;Zhao Peng;Yang Hongyu;Chen Yanjie;Xie Yanqiu;Tian Jiawei;Ren Min(Department of Ultrasound,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China;Department of Ultrasound Medicine,Shanghai First Maternity and Infant Hospital,Tongji University School of Medicine,Shanghai 201200,China;Department of Abdominal Ultrasound,the Affiliated Hospital of Qingdao University,Qingdao 266005,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,150086 [2]同济大学附属第一妇婴保健院超声科,上海201200 [3]青岛大学附属医院腹部超声科,266005

出　　处：《中华超声影像学杂志》2020年第5期443-448,共6页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(81571680);黑龙江省博士后启动基金(LBH-Q17124)。

摘　　要：目的:采用超声斑点追踪成像(STI)多层分析技术联合小剂量多巴酚丁胺负荷实验评价兔心肌缺血ATP药物后适应模型的心肌储备效应。方法:将40只兔随机分为缺血再灌注组(IR组)和ATP药物后适应组(ATP-PostC组)。两组分别于冠状动脉阻断前、阻断后60 min(多巴酚丁胺负荷前后)、再灌注后120 min(多巴酚丁胺负荷前后)行超声心动图检查,采集图像并获得左室局部心内膜纵向应变(SLsys-endo)、心肌纵向应变(SLsys-mid)、心外膜纵向应变(SLsys-epi),记录各房室腔大小并计算左室射血分数(LVEF),测量心率。每组于冠脉阻断后、多巴酚丁胺负荷后及再灌注后随机处死2只兔进行伊文思蓝-TTC双染色检查。结果:①冠脉阻断60 min后,两组LVEF减低(均P<0.05),SLsys-endo、SLsys-mid、SLsys-epi绝对值明显减低(均P<0.01);多巴酚丁胺负荷后,两组SLsys-endo、SLsys-mid、SLsys-epi绝对值增高,与阻断后比较差异有统计学意义(均P<0.05)。②再灌注120 min后,两组心肌各层纵向应变较阻断后均增高(P<0.01,P<0.05),且ATP-PostC组增高幅度明显高于IR组(P<0.01);IR组与第一次多巴酚丁胺负荷后比较差异无统计学意义(P>0.05);再次多巴酚丁胺负荷后,两组左室SLsys-endo、SLsys-mid绝对值进一步增高,与再灌注后比较差异有统计学意义(P<0.05);ATP-PostC组心肌局部纵向应变绝对值高于IR组(P<0.05)。③病理学结果,阻断60 min后,IR组与ATP-PostC组心肌梗死面积差异无统计学意义(P>0.05);再灌注120 min后,IR组心肌梗死面积百分比明显大于ATP-PostC组,差异有统计学意义(P<0.05)。结论:STI多层分析应变技术联合多巴酚丁胺负荷实验可早期判定局部心肌功能异常和准确评估心肌储备功能,心内膜纵向应变更为敏感。Objective To evaluate the myocardial reserve effect in rabbits′model of myocardial inshemia-reperfusion by layer-specific strain of speckle tracking imaging and low dose dobutamine stress echocardiography(LDDSE).Methods Forty rabbits were randomly divided into two groups:ischemia-reperfusion group(IR group)and pharmacological postconditioning group(ATP-PostC group).Echocardiography examinations were performed at baseline,60 min after ligation(before and after dobutamine stress),and 120 min after reperfusion(before and after dobutamine stress).The size of each chamber was measured and the left ventricular ejection fraction(LVEF)was calculated and the heart rate was recorded.The longitudinal strain of endocardium(SLsys-endo),longitudinal strain of myocardium(SLsys-mid),longitudinal strain of epicardium(SLsys-epi)were acquired.Triphenyl tetrazolium chloride(TTC)and Evans blue staining were applied in two rabbits randomly selected from each group at 60 min after ligation,dobutamine stress and 120 min after reperfusion,respectively.Results①After coronary artery ligation,LVEF decreased in both groups(P<0.05),SLsys-endo,SLsys-mid,and SLsys-epi decreased in two groups(P<0.01).After low dose dobutamine stress,the SLsys-endo,SLsys-mid and SLsys-epi in the two groups increased,which was different from that after lagation(P<0.05).②After 120 min reperfusion,the longitudinal strain of the myocardium of both groups increased compared with that after lagation(P<0.01,P<0.05),and the increase in ATP-PostC group was significantly higher than that in IR group(P<0.01).There was no significant difference between the IR group and the first LDDSE(P<0.05).After LDDSE again,the SLsys-endo and SLsys-mid in the two groups further increased,which was different from that after reperfusion(P<0.05).And the SLsys-endo and SLsys-mid were higher in ATP-PostC group than those in IR group(P<0.05).③Pathological results showed that there was no significant difference in myocardial infarct size between IR group and ATP-PostC group at 60 min aft

关 键 词：斑点追踪成像 心肌缺血 药物后适应 多巴酚丁胺负荷 存活心肌 

分 类 号：R542.22[医药卫生—心血管疾病]