基于超声分层应变成像技术评价苓桂气化方改善射血分数保留心力衰竭早期大鼠心肌功能的研究  

Ultrasonic layer-specific strain imaging for evaluating myocardial function in rats with early stage of heart failure with preserved ejection fraction by Linggui Qihua Formula

作　　者：李知轩 杨晨光 石玉姣 乔文博 董国菊[2,4] LI Zhixuan;YANG Chenguang;SHI Yujiao;QIAO Wenbo;DONG Guoju(Department of Ultrasonography of Xiyuan Hospital of Chinese Academy of Traditional Chinese Medicine,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院超声科,北京100091 [2]中国中医科学院西苑医院心血管一科,北京100091 [3]中国中医科学院研究生院 [4]国家中医心血管病临床医学研究中心

出　　处：《环球中医药》2024年第6期1007-1013,共7页Global Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82074423);中国中医科学院科技创新重大攻关项目(CI2021A00903)。

摘　　要：目的基于超声分层应变成像技术评价苓桂气化方改善射血分数保留心力衰竭(heart failure with preserved ejection fraction,HFpEF)早期大鼠心肌功能。方法40只SPF级SHR大鼠随机分为HFpEF模型组、恩格列净组、苓桂气化方低剂量组和苓桂气化方高剂量组,10只WKY大鼠为空白组。采用高盐高脂高糖饮食及腹腔注射链脲佐菌素建立HFpEF早期大鼠模型,各组予相应干预9周后测量左室舒张末期内径、左室舒张末期后壁厚度、舒张早期血液速度/舒张早期二尖瓣环间隔侧组织多普勒频谱、左室射血分数以及左室心内膜下心肌整体纵向应变、中层心肌整体纵向应变、心外膜下心肌整体纵向应变、心内膜下心肌整体圆周应变、中层心肌整体圆周应变和心外膜下心肌整体圆周应变。酶联免疫吸附法测定血清B型脑尿钠肽。马松染色观察心肌组织病理变化。结果与模型组比较,恩格列净组心内膜下心肌整体纵向应变、中层心肌整体纵向应变和心内膜下心肌整体圆周应变明显升高(P<0.05),苓桂气化方低剂量组心内膜下心肌整体纵向应变和中层心肌整体纵向应变明显改善(P<0.05),苓桂气化方高剂量组心内膜下心肌整体纵向应变、中层心肌整体纵向应变和中层心肌整体圆周应变明显提升(P<0.05)。苓桂气化方低剂量组和苓桂气化方高剂量组心肌细胞间隙变窄,胶原纤维沉积减少。结论苓桂气化方能提高HFpEF早期模型大鼠心内膜下心肌整体纵向应变、中层心肌整体纵向应变、中层心肌整体圆周应变,改善左室重构和收缩功能。超声分层应变成像技术可以无创、定量、敏感检测HFpEF早期大鼠左室壁心肌改变。Objective To assess the efficacy of the Linggui Qihua Formula in enhancing myocardial function in early-stage rats with heart failure with preserved ejection fraction(HFpEF)using ultrasonic layer-specific strain imaging technology.Methods 40 SPF-grade SHR rats were randomly assigned to the HFpEF model group,empagliflozin group,low-dose Linggui Qihua Formula group,and high-dose Linggui Qihua Formula group,while 10 WKY rats were assigned to the control group.The early-stage rat model of HFpEF was established by a high-salt,high-fat,and high-sugar diet along with intraperitoneal injection of streptozotocin.After 9 weeks of respective interventions,measurements were taken for left ventricular end-diastolic diameter(LVEDd),left ventricular posterior wall thickness(LVPWd),E/e′,left ventricular ejection fraction(LVEF),as well as global longitudinal strain(GLS)and global circumferential strain(GCS)at the endocardium(endo),midmyocardium(mid),and epicardium(epi)of the left ventricle.The levels of BNP in serum were detected by the method of enzyme-linked immunosorbent assay.The changes in myocardial tissue were observated using masson staining.Results Compared with the model group,the levels of GLSendo,GLSmid,and GCSendo showed a significant increase in the empagliflozin group(P<0.05).The levels of GLSendo and GCSmid were significantly improved in the low-dose group of Linggui Qihua Formula(P<0.05).The levels of GLSendo,GLSmid and GCSmid exhibited a significant increase in the high-dose group of Linggui Qihua Formula(P<0.05).The intercellular gap of cardiomyocytes were decreased while collagen fiber deposition were reduced in both the low-dose and the high-dose groups.Conclusion The Linggui Qihua Formula can enhance the levels of GLSendo,GLSmid,and GCSmid in the early-stage HFpEF model rats,improving left ventricular remodeling and systolic function.The application of ultrasonic layer-specific strain imaging technology enables non-invasive,quantitative,and sensitive detection of myocardial changes in the left ventricular

关 键 词：射血分数保留心力衰竭早期 二维超声斑点追踪技术 分层应变 苓桂气化方剂 心肌功能 

分 类 号：R285.5[医药卫生—中药学]