干旱区生态环境知识资源中心(Arid): 二维应变成像结合腺苷负荷超声心动图评价犬存活心肌

Arid

	二维应变成像结合腺苷负荷超声心动图评价犬存活心肌
其他题名	Evaluation of viable myocardium by two-dimensional strain imaging combined with adenosine stress echocardiography in dogs underwent experimental ischemia/reperfusion injury
	方玲玲 1; 张平洋 1; 王冲 1; 马小五 1; 史宏伟 2; 汪黎明 3; 冯雪虹 1
来源期刊	中华心血管病杂志
ISSN	0253-3758
出版年	2010
卷号	38 期号:9 页码:829-833
中文摘要	目的探讨二维应变成像结合腺苷负荷超声心动图评价存活心肌的新方法.方法 15只健康杂种犬,结扎其冠状动脉前降支90 min后,恢复血流灌注120 min,建立急性心肌梗死再灌注模型.分别于基础状态下(结扎前)和再灌注后采集心尖三腔、两腔和短轴二尖瓣、乳头肌、心尖水平的图像.随后泵人腺苷并重复采集图像.以氯化三苯基四氮唑溶液(2,3,5-triphenyl tetrazolium chloride,TTc)染色结果测量梗死面积(SN)与该节段总面积(S)的百分比(SN/S),S_N/S≤50%即为存活心肌.将前壁、前间壁各节段分为存活心肌和非存活心肌,运用二维应变成像技术定量评价犬不同状态下存活与非存活心肌径向、纵向及圆周的收缩期峰值应变(peak-systolic strain,S_(pcak sys))并进行比较.结果存活与非存活心肌分别为37和53个节段.(1)基础状态下:存活与非存活心肌的收缩期峰值径向应变(RS_(pcak sys))、纵向应变(LS_(pcak sys))及圆周应变(CS_(pcak sys))比较差异无统计学意义.(2)再灌注120 min后:存活与非存活心肌的RS_(pcak sys)、LS_(pcak sys) 及CS_(pcak sys)(绝对值)均低于基础状态,而存活心肌与非存活心肌组间差异无统计学意义.(3)腺苷负荷后:与再灌注120 min后相比,存活心肌的RS_(pcak sys)LS_(pcak sys)显著升高(P<0.01或P<0.05),且存活心肌的RS_(pcak sys)LS_(pcak sys)明显高于非存活心肌(P<0.01).(4)腺苷负荷后,RS_(pcak sys)与S_N/S呈负相关(r=- 0.72,P<0.01),CS_(pcak sys)及 LS_(pcak sys)与S_N/S呈正相关(r值分别为0.40和0.67,P均<0.01).(5)将腺苷负荷前、后应变数值的变化率(ARS_(pcak sys)和△LS_(pcak sys))作为研究对象,以△RS_(pcak sys)≥13.5%作为判断心肌存活的最佳截断值,其识别存活心肌的敏感性和特异性分别为83.8%、83.0%;以△LS_(pcak sys)≥11%作为最佳截断值,其敏感性和特异性分别为78.4%、88.7%;联合△RS_(pcak sys)和△LS_(pcak sys)两项指标,其敏感性和特异性分别为91.9%、79.2%,结论二维应变成像技术结合腺苷负荷超声心动图能比较准确地区分存活心肌与非存活心肌
英文摘要	Objective To explore the feasibility of evaluating viable myocardium with twodimensional strain imaging combined with adenosine stress echocardiography. Methods Acute myocardial infarction and reperfusion model was made by ligating anterior descending coronary artery for 90 minutes followed by 120-minute reperfusion in 15 healthy mongrel dogs. Images were acquired at baseline and after reperfusion. Adenosine was then infused and image acquisition repeated. Regional peak-systolic strain in radial, circumferential and longitudinal motion on anterior wall and anterior septum were measured. TTC staining served as agold standard"to define viable and nonviable myocardium. The ratio of infarct area (S_N) to total area(S)was calculated and viable myocardium was defined with S_N/S≤50%. Results At baseline,RSpeak sys,CSpeak sys and LS_(pcak sys) were similar between viable(n=37) and nonviable myocardial segments (n,= 53) and significantly decreased after reperfusion in both viable and nonviable myocardial segments. Compared with values obtained after reperfusion,LS_(pcak sys)and RS_(pcak sys) remained unchanged in nonviable myocardial segments and significantly increased in viable myocardial segments after adenosine (P <0.05). Post adenosine RSpeak sys was negatively correlated with S_N/S and CSpeak sys arid LSpeak sys were positively correlated with S_N/S. With △RS_(pcak sys) (before and after adenosine)≥13.5%, the sensitivity was 83.8% and specificity was 83.0% for distinguishing viable from nonviable myocardial segment. With △LS_(pcak sys)≥11% as cutoff value, the sensitivity was 78.4% and specificity was 88.7% for distinguishing viable from nonviable myocardial segment. Combining ARSpeaksys and ALSpeak,ys, the sensitivity and specificity for distinguishing viable from nonviable myocardial segment were 91.9% and 79.2%, respectively. Conclusions Two-dimensional strain imaging combined with adenosine stress echocardiography could quantitatively identify viable and nonviable myocardium
中文关键词	心肌梗死 ; 超声心动描记术 ; 压力 ; 心肌再灌注
英文关键词	Myocardial infarction Echocardiography stress Myocardial reperfusion
语种	中文
国家	中国
收录类别	CSCD
WOS类目	MEDICINE GENERAL INTERNAL
WOS研究方向	General & Internal Medicine
CSCD记录号	CSCD:4009961
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/226094
作者单位	1.南京医科大学附属南京第一医院心血管超声科, 210006; 2.南京医科大学附属南京第一医院麻醉科; 3.南京医科大学附属南京第一医院心胸外科
推荐引用方式 GB/T 7714	方玲玲,张平洋,王冲,等. 二维应变成像结合腺苷负荷超声心动图评价犬存活心肌[J],2010,38(9):829-833.
APA	方玲玲.,张平洋.,王冲.,马小五.,史宏伟.,...&冯雪虹.(2010).二维应变成像结合腺苷负荷超声心动图评价犬存活心肌.中华心血管病杂志,38(9),829-833.
MLA	方玲玲,et al."二维应变成像结合腺苷负荷超声心动图评价犬存活心肌".中华心血管病杂志 38.9(2010):829-833.