Application of Speckle-Tracking Echocardiography in an Experimental Model of Isolated Subendocardial Damage
Application of Speckle-Tracking Echocardiography in an Experimental Model of Isolated Subendocardial Damage
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DOI：
10.1016/j.echo.2017.08.006
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发表时间：
2017-12-01
影响因子：
6.5
通讯作者：
Kintscher, Ulrich
中科院分区：
文献类型：
--
作者：
Beyhoff, Niklas;Brix, Sarah;Kintscher, Ulrich
背景：心内膜下高度容易受到损害，因此即使在亚临床疾病阶段也受到影响。因此，反映心脏内膜状态的方法对于早期发现心脏损伤和预防功能障碍具有很大的临床相关性。这项研究的目的是调查心肌菌株参数的潜在能力。方法：雄性129/SV小鼠被注射异丙肾上腺素（ISO; n = 32）诱导分离的心脏心脏纤维纤维性疾病或适当的盐度。控制（n = 15）。经胸膜超声心动图使用与高分辨率成像系统耦合的30 MHz线性频率换能器进行，并分析了获取的图像以获取常规和应变参数。通过组织学分析来量化不同心脏层中胶原蛋白含量的程度，并评估了金属蛋白酶-1的组织抑制剂的血清水平（一种用于纤维化的生物标志物）的血清抑制剂。回报：ISO治疗引起的细胞下心脏胶原蛋白含量的明显增加，响应细胞的响应损失（对照与ISO，0.6 6 +/- 0.3％vs 5.8 +/- 6 +/- 0.9％; p < .001），并导致左心室壁厚的中等增加，并保留了收缩功能。在ISO处理的动物中，全球纵向峰值应变（LS）和纵向应变率显着降低（LS，-15.49％vs -11.49％[P = .001]；纵向应变率，-4.81 vs -3.88 sec（-1） [p <.05]），而径向和圆周应变值保持不变。全局LS与心内膜下胶原蛋白含量（r = 0.46，p = .01）和金属蛋白酶-1血清水平的组织抑制剂有关（r = 0.52，p <.05）。进一步的统计分析将全局LS确定为存在心脏纤维化的出色预测指标（灵敏度，84％；特异性，80％；截止值，-14.4％）。结论：LS的评估可能会为检测心脏心脏的心内心脏的方法提供无创方法。损害，因此可能会改善心脏疾病的早期诊断。
Background: The subendocardiumis highly vulnerable to damage and is thus affected even in subclinical disease stages. Therefore, methods reflecting subendocardial status are of great clinical relevance for the early detection of cardiac damage and the prevention of functional impairment. The aim of this study was to investigate the potential ability of myocardial strain parameters to evaluate changes within the subendocardium.Methods: Male 129/Sv mice were injected with isoproterenol (ISO; n = 32) to induce isolated subendocardial fibrotic lesions or saline as appropriate control (n = 15). Transthoracic echocardiography was performed using a 30-MHz linear-frequency transducer coupled to a high-resolution imaging system, and acquired images were analyzed for conventional and strain parameters. The degree of collagen content within the different cardiac layers was quantified by histologic analysis and serum levels of tissue inhibitor of metalloproteinase-1, a biomarker for fibrosis, were assessed.Results: ISO treatment induced a marked increase in subendocardial collagen content in response to cell loss (control vs ISO, 0.6 6 +/- 0.3% vs 5.8 +/- 6 +/- 0.9%; P < .001) and resulted in a moderate increase in left ventricular wall thickness with preserved systolic function. Global longitudinal peak strain (LS) and longitudinal strain rate were significantly decreased in ISO-treated animals (LS,-15.49% vs -11.49% [P = .001]; longitudinal strain rate, -4.81 vs -3.88 sec(-1) [P < .05]), whereas radial and circumferential strain values remained unchanged. Global LS was associated with subendocardial collagen content (r = 0.46, P = .01) and tissue inhibitor of metalloproteinase-1 serum level (r = 0.52, P < .05). Further statistical analyses identified global LS as a superior predictor for the presence of subendocardial fibrosis (sensitivity, 84%; specificity, 80%; cutoff value,-14.4%).Conclusion: Assessment of LS may provide a noninvasive method for the detection of subendocardial damage and may consequently improve early diagnosis of cardiac diseases.