Deterioration of longitudinal, circumferential, and radial myocardial strains during acute coronary flow reduction: which direction of strain should be analyzed for early detection?
Deterioration of longitudinal, circumferential, and radial myocardial strains during acute coronary flow reduction: which direction of strain should be analyzed for early detection?
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DOI：
10.1007/s10554-020-01888-4
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发表时间：
2020-05-28
影响因子：
2.1
通讯作者：
Nakatani, Satoshi
中科院分区：
文献类型：
--
作者：
Adachi, Hitomi;Asanuma, Toshihiko;Nakatani, Satoshi
与周向和径向应变相比，纵向心肌应变被认为在缺血早期会恶化，因为心内膜下内斜纤维通常沿着纵轴定向。然而，目前尚不清楚在急性冠状动脉血流减少期间纵向应变的减少是否先于周向和径向应变的减少。13只开胸犬左前降支逐渐狭窄。在基线和流量减少过程中，分析了全壁和内膜下的纵向、周向和径向应变。在危险区测量收缩期峰值和收缩末期应变、收缩后应变指数（PSI）和收缩早期应变指数（ESI）;评价每个参数的下降率和检测血流减少的诊断准确性。收缩期峰值应变和收缩末期应变的绝对值随血流减少而逐渐减小。纵向收缩应变的下降率和诊断准确性与其他应变无显著差异，但径向收缩应变的诊断准确性有降低的趋势。PSI和ESI随着流量的减小而逐渐增大。在这些参数中，未证明径向应变的诊断准确性较低。在急性冠状动脉血流减少期间，纵向收缩应变的降低并不先于周向收缩应变的降低;然而，径向收缩应变的降低可能小于其他收缩应变的降低。与此相反，似乎没有差异的PSI和ESI值之间的三个菌株。
Longitudinal myocardial strain is considered to deteriorate in the early ischemic stage compared to circumferential and radial strains because the subendocardial inner oblique fibers are generally directed along the longitudinal axis. However, it is unclear whether the decrease in longitudinal strain precedes a decrease in circumferential and radial strains during acute coronary flow reduction. The left anterior descending artery was gradually narrowed in 13 open-chest dogs. Whole-wall and subendocardial longitudinal, circumferential, and radial strains were analyzed at baseline and during flow reduction. Peak systolic and end-systolic strains, the postsystolic strain index (PSI), and the early systolic strain index (ESI) were measured in the risk area; the decreasing rate in each parameter and the diagnostic accuracy to detect flow reduction were evaluated. Absolute values of peak systolic and end-systolic strains gradually decreased with flow reduction. The decreasing rate and diagnostic accuracy of longitudinal systolic strain were not significantly different from those in other strains, although the diagnostic accuracy of radial systolic strain tended to be lower. PSI and ESI gradually increased with flow reduction. In these parameters, a lower diagnostic accuracy with respect to radial strain was not demonstrated. During acute coronary flow reduction, the decrease in longitudinal systolic strain did not precede that in circumferential systolic strain; however, the decrease in radial systolic strain may be smaller than that of other systolic strains. In contrast, there appeared to be no differences in the PSI and ESI values among the three strains.