摘要
目的:应用二维斑点追踪显像(2D-STI)分层应变技术评价急性心肌缺血早期左室整体和局部收缩功能。方法:对40只健康大白兔开胸行冠状动脉左室支结扎术建立急性心肌缺血模型,采用心脏超声诊断仪于术前、术后分别采集心尖四腔心、长轴、二腔心切面以及短轴二尖瓣水平、乳头肌水平、心尖水平切面二维动态图像。应用GE Echo PAC软件脱机分析左室整体应变及18节段的收缩期纵向、周向三层心肌(心内膜下心肌、中层心肌、心外膜下心肌)峰值应变。结果:对40只兔子进行长轴纵向应变分析;由于短轴图像质量原因,对成功追踪短轴切面的30只兔子进行周向应变分析。常规参数:兔术前、术后心率(HR)的差异有统计学意义(P<0.05),而室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室舒张末期内径(LVDd)、左房内径(LAD)、左室射血分数(LVEF)差异均无统计学意义(P>0.05)。整体应变:左室三层心肌整体纵向应变(GLS)、整体周向应变(GCS)及整体跨壁梯度ΔGLS、ΔGCS术后均显著低于术前(P<0.001)。左室GLS、GCS自心内膜下心肌至心外膜下心肌逐层递减(P<0.001)。长轴节段应变:左室侧壁、前间隔、前壁心内膜下心肌、中层心肌、心外膜下心肌纵向收缩期峰值应变术后均显著低于术前(P<0.05)。中间段及心尖段左室下、后壁心内膜下心肌、中层心肌、心外膜下心肌纵向收缩期峰值应变术后均显著低于术前(P<0.05)。基底段、中间段后间隔及基底段下、后壁三层心肌的纵向收缩期峰值应变术前、术后的差异无统计学意义(P>0.05),但术后低于术前。短轴节段应变:中间段左室前壁、侧壁、下壁心内膜下心肌及基底段前间隔、后间隔的心外膜下心肌的周向收缩期峰值应变术后均显著低于结扎前(P<0.05)。其余各节段三层心肌周向收缩期峰值应变的术前、术后的差异无统计学意义(P>0.05),但术后较结扎
Objective：Using two-dimensional speckle tracking imaging（2D-STI） to analysis layer-specific strain of rabbits＇ left ventricular（LV） in the early stage of acute myocardial ischemia（AMI）,which is to assess global and regional systolic function of LV.Methods：AMI model of forty white rabbits was established through ligating the left ventricular branch of coronary artery.Two-dimensional images were recorded and stored in apical fourchamber,long-axis,two-chamber and the short-axis view at the level of mitral valve,papillary muscle and apex.The highest value of longitudinal strain（LS）,circumferential strain（CS）,global longitudinal strain（GLS） and circumferential strain（GCS）,using Echo PAC was respectively assessed from endocardium,mid-myocardium and epicardium of 18 sections.Results：AMI model of forty white rabbits was successfully established to conduct longitudinal strain analysis,and 30 rabbits to conduct circumferential strain analysis because 10 rabbits were excluded due to quality control requirement.The difference in HR between preoperative and postoperative was significant,but t IVST,LVPWT,LVDd,LAD and LVEF was not.The difference in three-layer GLS,GCS,global gradient-longitudinal stain（ΔGLS） and global gradient-circumferential stain（ΔGCS） was significant（P〈0.001）and the value was lower than the preoperative one.The values of GLS and GCS were the highest in endocardium and the lowest in the epicardium（P〈0.001）.The value of long-axis in endocardium,mid-myocardium and epicardium of left lateral,anterior and anterior septum wall all showed a great decrease（P〈0.05）.The value of LS in three-layer of inferior,posterior wall of left middle and apex sections was decreased after the operation（P〈0.05）.The value of LS in three-layer of posterior septum of basal,middle segment and inferior,posterior of basal segment decreased,but there was no significant difference（P〉0.05）.The value of CS in endocardium of left anterior,lateral,inferior wall of midd
作者
孔凡峰
颜紫宁
范莉
黄俊
KONG Fan-feng;YAN Zi-ning;FAN Li;HUANG Jun(Echocardiogram Room, Changzhou Second People＇s Hospital Affiliated to Nanjing Medical University, Changzhou 213003, China)
出处
《现代医学》
2017年第11期1562-1568,共7页
Modern Medical Journal
基金
常州市卫生计生委重大科技项目(ZD201605)
关键词
二维斑点追踪显像
分层应变
纵向应变
周向应变
兔
two- dimensional speckle tracking imaging
layer- specific strain
longitudinal strain
circumferential strain
rabbits
