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目的:探讨应用多普勒组织运动成像技术(DTI,Dopplar Tissue Motion Imaging)评价实验猪心肌梗死再灌注治疗后左室功能变化的价值。方法:取试验用家猪24头,随机分成2组,A组(10头)B组(14头)。A组作为对照组,未做任何处置,只是在相应时间点获取数据。B组实验猪经开胸,于前降支起始1 cm处,放置特制银夹,可以缓慢夹闭前降支血管,银夹自放置至完全闭合需6小时,9小时后再次开胸,取出银夹,进行心肌再灌注。A组与B组夹闭前、夹闭后6小时造影检查确定前降支完全闭塞、9小时闭塞状态取出银夹、12小时再灌注3小时进行常规超声心动图检查和DTI,获取对照组和模型组夹闭前、夹闭后6小时、9小时、12小时的左室舒张末期内径Edd(Left Ventricular End Diastolic Diameter)、收缩末期内径Esd(Left Ventricular End Systolic Diameter)、每搏输出量SV(cardiac stroke volume)、射血分数EF(ejection fraction)、短轴缩短率Fs(Fraction Shortening);舒张期二尖瓣前向血流频谱E峰、A峰、E/A等常规参数。转TVI(Tissue Velocity Imaging)模式下DTI测量二尖瓣环组织运动参数:收缩期峰值速度Sa、舒张早期峰值速度Ea、舒张晚期峰值速度Aa、及Ea/Aa。结果:1).B组实验猪在夹闭6小时、9小时、12小时DTI所测数据Sa峰值变化比常规数据变化明显(P<0.01)2)。DTI所测数据Ea、Aa、Ea/Aa变化较舒张期二尖瓣前向血流数据E峰、A峰、E/A变化出现早。3).病理显示夹闭9小时时前壁心肌出现坏死,心肌细胞被破坏及炎细胞浸润。结论:DTI可以准确及时评价实验猪急性心肌梗死再灌注治疗左室功能的变化。
Objective: To evaluate the value of using Doppler Tissue Motion Imaging (DTI) to evaluate left ventricular function after myocardial infarction reperfusion in pigs. Methods: Twenty-four domestic pigs were randomly divided into two groups, Group A (10) Group B (14). Group A as a control group, without any treatment, but at the appropriate time to obtain data. Group B experimental thoracotomy, in the anterior descending branch at the beginning of 1 cm, place a special silver clip, you can slowly clamp the anterior descending artery, silver clip from the placement to completely closed for 6 hours, 9 hours after re-open the chest, Remove the silver clip for myocardial reperfusion. A group and B group before clipping, 6 hours after clipping, angiography confirmed complete anterior descending artery occlusion, 9 hours after the occlusion was removed silver clip, 12 hours after reperfusion 3 hours for echocardiography and DTI, access to the control group and The left ventricular end diastolic diameter (Edd), left ventricular end systolic diameter (EDD), stroke volume at each time point of 6 h, 9 h and 12 h after clipping in model group were cardiac stroke volume, ejection fraction, shortening fraction Fs (Fraction Shortening); E-peak, peak A, E / A and other parameters of diastolic mitral flow. Tissue Velocity Imaging (DTI) was performed in TVI (Tissue Velocity Imaging) mode to measure mitral annulus tissue motion parameters: systolic peak velocity Sa, early diastolic velocity Ea, late diastolic peak velocity Aa, and Ea / Aa. Results: 1) The peak value of Sa measured by DTI at 6 hours, 9 hours and 12 hours after clipping in experimental pigs in group B was significantly higher than that of routine data (P <0.01) 2). DTI measured data Ea, Aa, Ea / Aa changes in diastolic mitral valve forward blood flow data E peak, A peak, E / A changes early. 3) Pathology showed necrosis of the anterior wall myocardium 9 hours after clipping, destruction of cardiomyocytes and inflammatory cell infiltration. Conclusion: DTI can accurately and timely evaluate the changes of left ventricular function in experimental pigs with acute myocardial infarction and reperfusion.