摘要
目的应用新型的速度向量成像(VVI)结合心肌声学造影(MCE)评价冠脉狭窄时心肌收缩、舒张功能及血流灌注三者之间的关系。方法不同程度冠脉(前降支)狭窄的实验犬模型8只,在冠脉狭窄前后于静息和多巴酚丁胺负荷时,取左室短轴图像进行VVI分析并行MCE,测量心肌血流量(A·β值)和短轴圆周方向上收缩期(SRsys)和舒张期峰值应变率(SRdia)。结果静息下,只有当重度冠脉狭窄时,其供血区的SRsys、SRdia和A·β值才均低于狭窄前(-1.1±0.50vs-1.62±0.50,1.19±0.48vs1.75±0.51,0.4±0.21vs0.80±0.47,P<0.05)。负荷时,与狭窄前相比,狭窄冠脉供血区的SRsys、SRdia和A·β值随冠脉狭窄程度的加重而改变,呈递减关系(-4.31±1.14vs-3.20±0.98vs-1.18±0.64,4.51±1.13vs3.39±0.98vs1.37±0.64,3.54±1.95vs1.81±0.89vs0.82±0.42,P<0.05)。无论静息还是负荷时,SRsys和SRdia(r静息=0.88,r负荷=0.96,P<0.01),SRsys和A·β(r静息=0.55,r负荷=0.71,P<0.01)以及SRdia和A·β(r静息=0.57,r负荷=0.72,P<0.01)间均呈良好相关性。结论VVI和MCE结合能够用于动态评价短轴心肌节段舒缩功能和血流灌注的变化情况,且VVI通过对心肌舒缩功能的评价能在一定的程度上反映心肌血流灌注的情况。
Objective To evaluate the relationship between myocardial systolic, diastolic functions and perfusion in coronary artery stenosis using velocity vector imaging （VVI） and myocardial contrast echocardiography （MCE）. Methods Stenoses in the anterior descending branch of the coronary artery were induced in 8 dogs. Before and after coronary artery stenosis, two-dimensional images of the left ventricular mastoid muscle section on the short axis at rest and in the peak dose of dobutamine were obtained for evaluation of VVI and MCE. The myocardial blood flow A .β values, peak systolic strain rate （SRsys） and peak diastolic strain rate （SRdia） in the direction of the circumference of the short axis were measured. Results At rest, only severe coronary stenosis resulted in significantly lowered SRsys, SRdia and A·β value of the stenotic bed compared to the values before the stenosis （-1.1±0.50 vs -1.62±0.50, 1.19±0.48 vs 1.75±0.51, 0.4±0.21 vs 0.80±0.47, P〈0.05）. In stress, SRsys, SRdia and A ·β value of the stenotic bed gradually decreased as coronary stenosis worsened （-4.31± 1.14 vs -3.20±0.98 vs -1.18±0.64, 4.51±1.13 vs 3.39±0.98 vs 1.37±0.64.3.54±1.95 vs 1.81±0.89 vs 0.82±0.42, P〈0.05）. Both at rest and in stress, good correlations were noted between SRsys and SRdia （rrest=0.88, rstress=0.96, P〈0.01 ）, between SRsys and the standard A ·β values （rrest=0.56, rstress=0.71, P〈0.01）, and between SRdia and A ·β （rrest=0.57, rstress=0.72, P〈0.01） in the direction of the circumference of the short axis. Conclusions Using VVI and MCE, the changes in myocardial perfusion and the systolic and diastolic functions in the direction of the circumference can be observed dynamically. VVI may help assess the condition of myocardial perfusion by evaluating the systolic and diastolic function.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2009年第9期1761-1765,共5页
Journal of Southern Medical University
基金
国家"863"科技计划项目(2006AA02Z478)
关键词
速度向量成像
心肌声学造影
组织多普勒成像
应变率
velocity vector imaging
myocardial contrast echocardiography
tissue Doppler imaging
strain rate
