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心肌超声造影评价肥厚心肌血流灌注的跨壁分布异常 被引量:5

Abnormal myocardial perfusion in subendocardial and subepicardial layers of hypertrophied myocardium by myocardial contrast echocardiography
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摘要 目的探讨心肌超声造影在评价肥厚心肌内外层冠状动脉微循环血流灌注不均一性的价值。方法 26只大鼠经腹主动脉缩窄术得到左心室肥厚模型(AC组),13只大鼠进行假手术(SH组)。分别喂养4周和8周,两组在手术前后均进行心肌超声造影。分别对心内膜下层心肌(endo)与心外膜下层心肌(epi)进行分析,得到造影成像的时间-强度曲线,读出血流灌注参数A、β、A·β值。计算每一测值的跨壁梯度,即心肌内、外膜层参数比值(EER)。结果 AC组心肌造影A、β和A·β较SH组均降低,AC组术后8周心内膜层心肌A、β和A·β均比心外膜层心肌减低。AC组术后8周心内膜下层心肌跨壁梯度(EER)较术后4周和SH组均减小(P<0.05)。结论心肌肥厚早期内膜层心肌β-endo降低;心肌肥厚中晚期内膜层心肌灌注量和速度均减少,出现心肌微循环灌注跨壁分布的异常。 Objective The abnormal microcirculation flow perfusion across the left ventricular wall of hypertrophied myocardium by myocardial contrast echocardiography(MCE) was evaluated to reveal microvascular dyfunction in early stages of left ventricular hypertrophy (LVH). Methods A group of twenty-six mice had LVH via abdominal aortic coaretation (AC) and a group of 13 mice with shammed operation as group sham-operation group(SH) were raised for 4 weeks and 8 weeks respectively. MCE was performed in each group. Regions of interest (ROI) were placed individually within subendoeardial and subepicardial myocardium, the parameters of A,β, A·β by time-intensive curve and subendocardial-to-subepieardial ratio (EER) were obtained. Results A, βand A· β decreased significantly in group AC than in group SH (P 〈 0.05). After 8 weeks of operation, A, β and A· β decreased significantly in subendocardium than in subepieardium of group AC ( P 〈 0.05 ). In subendoeardium, EER was decreased significantly in group AC than in that of group SH after 4 weeks of operation ( P 〈 0.05 ). Conclusions The significantly decreased myocardial blood flow and reperfnsion velocity were related to microvascular abnormalities induced by LVH. The hypoperfusion in subendocardial hypertrophic myoeardium was more worse along with the severity of LVM. MCE could be helpful for abnormal detection of myocardial perfusion in the early stage of LVH.
出处 《中华医学超声杂志(电子版)》 2010年第8期3-5,共3页 Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词 超声心动描记术 造影剂 肥厚性心肌病 血液灌注 Eehocardiography Contrast media Hypertrophic eardiomyopathy Hemoperfusion
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