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目的探讨卡维地洛对慢性心力衰竭兔心肌应变及应变率的作用,以评价其对心肌局部功能的影响和意义。方法30只日本大耳兔随机分为3组,分别为空白对照组(CTL组,6只)、慢性心力衰竭组(CHF组,12只)和卡维地洛干预心衰组(CVD组,12只)。CHF组和CVD组兔每周2次耳缘静脉注射盐酸阿霉素溶液(浓度:1mg.mL-1)1mL.kg-1,共计8周;对照组同期耳缘静脉注射等量生理盐水。对照组和模型组兔自第12周始每日以生理盐水(5mg.kg-1.d-1)灌胃,CVD组兔以等量卡维地洛生理盐水(浓度:1mg.mL-1)灌胃,共8周。分别于第12,20周测定3组兔血清B型钠尿肽(BNP)水平,心脏超声测定左心室舒张末期内径(LVEDD)、左室射血分数(LVEF)和缩短分数(FS)等,同时应用心肌应变率显像(SRI)技术检测3组兔左室侧壁和室间隔基底部心肌的收缩期和舒张早期峰值应变率(SRs和SRe)、收缩期和舒张期峰值应变(PSS和PDS)的变化。结果①CHF组和CVD组兔在12周时,其血清BNP水平较CTL组明显升高、LVEDD扩大、LVEF和FS下降,左室侧壁和室间隔基底部心肌SRs,SRe,PSS,PDS明显降低。②20周时,CVD组兔较12周时血清BNP水平和LVEDD明显下降、LVEF和FS明显升高,SRs,SRe,PSS,PDS显著增高;CHF组和对照组上述指标与第12周比较无明显变化。结论慢性心衰时局部心肌收缩期和舒张期峰值应变和应变率降低;卡维地洛可以改善心力衰竭兔整体心肌收缩功能、改善心脏重构;也可以增加收缩期和舒张期峰值应变及应变率,改善局部心肌收缩和舒张功能。
Objective To investigate the effect of carvedilol on myocardial strain and strain rate in rabbits with chronic heart failure and to evaluate its effect on myocardial local function. Methods Thirty rabbits were randomly divided into three groups: blank control group (CTL group, n = 6), chronic heart failure group (CHF group, n = 12) and carvedilol intervention group 12 only). The CHF group and the CVD group were injected with 1 mL.kg-1 of doxorubicin hydrochloride solution (concentration: 1 mg.mL-1) twice a week for a total of 8 weeks. The control group received the same amount of saline as the control group. The rabbits in the control group and model group were intragastrically administrated with normal saline (5mg.kg-1.d-1) daily from the 12th week. The rabbits in the CVD group were treated with equal volume of carvedilol saline (concentration: 1mg.mL-1 ) Gavage for a total of 8 weeks. The level of BNP, LVEDD, LVEF and FS of the rabbits in the three groups were measured at the 12th and 20th week, respectively. The left ventricular end-diastolic diameter (LVEDD) The myocardial systolic and early diastolic peak strain rates (SRs and SRe), systolic and diastolic peak strain (PSS and PDS) were measured by myocardial strain rate imaging (SRI) )The change. Results ① At 12 weeks, the levels of serum BNP in CHF group and CVD group were significantly higher than those in CTL group. The LVEDD, LVEF and FS decreased. The levels of SRs, SRe, PSS and PDS in left ventricular wall and ventricular base were significantly decreased. ② Serum BNP level and LVEDD were significantly decreased at 12 weeks in CVD group compared with those at 12 weeks, LVEF and FS were significantly increased, SRs, SRe, PSS and PDS were significantly increased in CHF group compared with those in the control group at 12 weeks Variety. Conclusions The peak strain and strain rate of local myocardial systolic and diastolic peak in chronic heart failure are decreased. Carvedilol can improve global myocardial contractile function and improve cardiac remodeling in rabbits with congestive heart failure. It can also increase peak strain and strain at systole and diastole Rate, improve local myocardial systolic and diastolic function.