Regional myocardial systolic function during acute myocardial ischemia assessed by strain Doppler echocardiography
Regional myocardial systolic function during acute myocardial ischemia assessed by strain Doppler echocardiography
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DOI：
10.1016/s0735-1097(00)01160-8
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发表时间：
2001-03-01
影响因子：
24
通讯作者：
Ihlen, H
中科院分区：
文献类型：
--
作者：
Edvardsen, T;Skulstad, H;Ihlen, H
目的评价超声心动图应变测量能否发现急性心肌缺血，并与心肌速度测量和室壁运动积分指数进行比较。背景：组织多普勒超声心动图(TDE)是一种有前途的局部心肌功能评价方法。然而，由于邻近组织的拴系效应，组织多普勒超声心动图(TDE)测得的心肌速度在整个左心室(LV)内各不相同。应变多普勒超声心动图(SDE)是一种不考虑邻近心肌组织影响的新型心肌局部形变测量方法。方法对17例冠状动脉左前降支成形术患者进行研究。分别在心尖四腔切面、心尖四腔切面、多个心肌节段同时应用TDE和SDE评价左室壁运动。结果非缺血左室壁各节段的收缩应变值分布均匀，收缩速度自基底部向心尖部递减。在LAD阻断期间，应变测量显示17例患者中有16例心尖间隔段扩张(7.5%+/-6.5%比-17.7%+/-7.2%，p<；0.001)，而间隔中段的压缩减少(p<；0.05)。不是由法援署提供的区段保持不变。组织多普勒超声心动图显示在血管成形术中所有间隔节段的血流速度降低(p(0.05)，尽管LAD不供应基础间隔。17例患者中有11例出现负收缩速度。室壁运动积分指数在缺血时增加(1.3+/-0.4，p<；0.05)。结论新的SDE方法可能比TDE更准确地检测LAD闭塞所致的局部收缩功能障碍。(J Am Coil心脏ol 2001；37：726-30)(C)2001，由美国心脏病学会出版。
OBJECTIVES We sought to evaluate if echocardiographic strain measurements could detect acute myocardial ischemia, and to compare this new method with myocardial velocity measurements and wall motion score index.BACKGROUND Tissue Doppler echocardiography (TDE) is a promising method for assessing regional myocardial function. However, myocardial velocities measured by tissue Doppler echocardiography (TDE) vary throughout the left ventricle (LV) because of tethering effects from adjacent tissue. Strain Doppler echocardiography (SDE) is a new tool for measuring regional myocardial deformation excluding the effect of adjacent myocardial tissue.METHODS Seventeen patients undergoing angioplasty of the left anterior descending coronary artery (LAD) were studied. Left ventricular longitudinal wall motion was assessed by TDE and SDE from the apical four-chamber view before, during and after angioplasty from multiple myocardial segments simultaneously.RESULTS Systolic strain values were uniformly distributed in the different nonischemic LV segments, whereas systolic velocities decreased from basis to apex. During LAD occlusion, strain measurement showed expansion in the apical septal segment in 16 of 17 patients (7.5 +/- 6.5% vs. -17.7 +/- 7.2%, p < 0.001) and reduced compression in the mid-septal segment (p < 0.05) compared with baseline. Segments not supplied by LAD remained unchanged. Tissue Doppler echocardiography showed reduced velocities in all septal segments (p ( 0.05) during angioplasty even though LAD does not supply the basal septal segment. Negative systolic velocities were present in 11 of 17 patients. Wall motion score index increased during ischemia (1.3 +/- 0.4, p < 0.05).CONCLUISONS The new SDE approach might be a more accurate marker than TDE for detecting systolic regional myocardial dysfunction induced by LAD occlusion. (J Am Coil Cardiol 2001;37: 726-30) (C) 2001 by the American College of Cardiology.