Assessment of Myocardial Ischemic Memory Using Speckle Tracking Echocardiography
Assessment of Myocardial Ischemic Memory Using Speckle Tracking Echocardiography
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DOI：
10.1016/j.jcmg.2011.09.019
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发表时间：
2012-01-01
影响因子：
14
通讯作者：
Nakatani, Satoshi
中科院分区：
文献类型：
--
作者：
Asanuma, Toshihiko;Fukuta, Yumi;Nakatani, Satoshi
目的：本研究的目的是评估斑点跟踪超声心动图获得的哪些区域心肌参数可以在短暂缺血-再灌注犬模型中显示心肌缺血记忆。心肌缺血记忆成像是指缺血引起的异常的可视化，即使在灌注恢复后也能持续，可以传递重要的临床信息。我们之前报道过短暂缺血恢复后收缩后缩短（PSS）仍在危险区域。然而，在短暂缺血缓解后，其他区域变形参数的异常是否仍然存在尚不清楚。方法对11只犬在冠脉闭塞后再灌注2分钟内的超声心动图数据按时间顺序进行采集。从径向和周向应变测量区域收缩和舒张变形参数，包括与PSS相关的参数，并从危险区域和正常区域的应变率分析。计算应变成像舒张指数（应变成像舒张指数，SI-DI），作为评估缺血记忆的参数。结果闭塞时危险区峰值收缩应变、收缩末期应变和峰值收缩应变率下降，再灌注后立即恢复到基线水平。闭塞时舒张早期应变率降低；然而，再灌注后，这种下降并不持续。PSS参数收缩后应变指数（PSI）和峰值时间应变指数（time-to-peak strain index）在咬合过程中增加。这些升高持续到再灌注后10 ~ 20分钟（周向PSI: 0.02 +/- 0.04[基线]vs. 0.08 +/- 0.04[20分钟]，p < 0.05）。由于SI-DI变化较大，遮挡期间SI-DI变化不明显。结论：虽然仅pss相关参数的异常在2分钟闭塞恢复后持续存在，但其他变形参数的异常，如舒张早期的应变率，并未出现异常。这些数据表明，通过斑点跟踪超声心动图评估PSS对检测心肌缺血记忆是有用的。[J]中华医学会心脏科杂志2012；5:1-11
OBJECTIVES The aim of this study was to evaluate which regional myocardial parameters derived from speckle tracking echocardiography could demonstrate myocardial ischemic memory in a brief ischemia-reperfusion dog model.BACKGROUND Myocardial ischemic memory imaging, denoting the visualization of abnormalities provoked by ischemia and sustained even after restoration of perfusion, can convey important clinical information. We previously reported that post-systolic shortening (PSS) remains in the risk area after recovery from brief ischemia. However, it is still unclear whether abnormalities in other regional deformation parameters persist after relief from brief ischemia.METHODS Echocardiographic data were chronologically acquired from 11 dogs during 2 min of coronary occlusion followed by reperfusion. Regional systolic and diastolic deformation parameters, including parameters related to PSS, were measured from radial and circumferential strain and from strain rate analyzed in the risk and normal areas. Strain imaging diastolic index (SI-DI), which had been proposed as a parameter for assessing ischemic memory, was also calculated.RESULTS Peak systolic strain, end-systolic strain, and peak systolic strain rate decreased in the risk area during occlusion but recovered to the baseline level immediately after reperfusion. Strain rate during early diastole decreased during occlusion; however, the decrease did not persist after reperfusion. Post-systolic strain index (PSI) and time-to-peak strain index, which are parameters of PSS, increased during occlusion. These increases persisted until 10 to 20 min after reperfusion (circumferential PSI: 0.02 +/- 0.04 [baseline] vs. 0.08 +/- 0.04 [20 min], p < 0.05). SI-DI did not show a significant change during occlusion because of a large variation.CONCLUSIONS Although abnormalities of PSS-related parameters alone persisted after recovery from 2-min occlusion, abnormalities of other deformation parameters, such as strain rate during early diastole, did not. These data suggest that assessment of PSS by speckle tracking echocardiography is useful for detecting myocardial ischemic memory. (J Am Coll Cardiol Img 2012; 5: 1-11) (C) 2012 by the American College of Cardiology Foundation