顿抑心肌局部心功能变化及其超声心动图评价的实验研究

Post ischemic recovery of regional left ventricular function in stunned canine myocardium estimated by echocardiography

本研究建立犬心肌缺血－再灌注模型，用二维超声心动图（２ＤＥ）测量的节段性室壁增厚率（ΔＴ）作为反映心肌局部收缩功能的指标，Ｍ型测量的舒张末期室壁变薄一半时的平均速率（ＲＨＥＤＴ）作为反映心肌局部舒张功能的指标，定量评价了阻断犬冠状动脉左前降支（ＬＡＤ）１５ｍｉｎ，再灌注１８０ｍｉｎ期间的心功能变化。结果表明：顿抑心肌局部收缩功能和舒张功能均受到抑制，功能的恢复为一渐进过程，两者的变化呈平行发展的趋势。该结果扩充了传统的顿抑心肌概念。

Abstract Anesthetized dogs were subjected to 15 min episodes of total left anterior descending coronary artery occlusion, followed by 180 min reperfusion to show the changes in regional myocardial function. The regional systolic function was measured by two dimensional ECHO with wall thickening (T) , and the regional diastolic function was estimated by M-mode ECHO with mean rate to half end-diastolic-thinning (RHEDT).Profound, prolonged abnormalities of regional systolic and diastolic function after a brief episode of ischemia were shown. Accordingly, our observation expands the concept of myocardium stunning from the traditional notion of impaired systolic performance to that of a global derangement in mechanical function involving both systolic and diastolic properties.