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目的:应用超声组织速度显像(TVI)技术研究左室局部心肌缺血时左室压力变化对左房功能的影响。方法:11只犬行左冠状动脉前降支结扎,制作左室前壁心肌缺血模型。应用TVI技术测量缺血前后心房各壁的收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)及二尖瓣口血流频谱E/A、肺静脉血流频谱S峰和D峰值,同时导管记录缺血前后左室压力曲线。结果:心肌缺血后左房各壁Vs和Ve均增高(P<0.001),左室舒张末期压力(LV-EDP)增高,且其缺血前后变化率(LVEDP%)分别与左房前壁、侧壁和下壁的Ve变化率(Ve%)呈正相关(r=0.72、0.73、0.83,P=0.05、0.05、0.002)。结论:左房功能在局部心肌缺血时会受到增高的LVEDP的影响,表现为左房壁心肌纤维的运动能力随之增加。
Objective: To study the effect of left ventricular pressure changes on left atrial function during left ventricular myocardial ischemia by using ultrasonic tissue velocity imaging (TVI). Methods: Eleven dogs underwent left anterior descending coronary artery ligation to make anterior left ventricular myocardial ischemia model. TVI technique was used to measure the peak systolic velocity (Vs), early diastolic peak velocity (Ve), E / A of mitral flow and S peak and D peak of pulmonary venous flow in each wall before and after ischemia, Left ventricular pressure curve was recorded before and after ischemia. Results: The levels of Vs and Ve increased significantly (P <0.001) and the left ventricular end-diastolic pressure (LV-EDP) increased after myocardial ischemia, and the changes of LVEDP% (Ve%) of side wall and inferior wall were positively correlated (r = 0.72,0.73,0.83, P = 0.05,0.05,0.002). CONCLUSIONS: Left atrial function is affected by increased LVEDP during local myocardial ischemia, as manifested by an increase in left ventricular myocardial capacity.