Contrast echocardiography in acute myocardial ischemia: I. In vivo determination of total left ventricular "area at risk".
Contrast echocardiography in acute myocardial ischemia: I. In vivo determination of total left ventricular "area at risk".
复制标题
急性心肌缺血的超声心动图对比：I.左心室总“危险区域”的体内测定。
DOI：
10.1016/s0735-1097(84)80149-7
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发表时间：
1984
影响因子：
24
通讯作者：
Weyman,AE
中科院分区：
文献类型：
--
作者：
Kaul,S;Pandian,NG;Okada,RD;Pohost,GM;Weyman,AE
心肌声学造影最近已被证明可以准确评估实验模型中急性冠状动脉闭塞后坏死的“危险区域”。然而，风险区域定量主要是从单个断层平面进行研究的。由于心肌坏死的三维范围取决于心肌的总体积的风险，总的左心室的“危险区”，在11只狗（A组），无论是左前降支或左回旋支动脉闭塞，使用造影超声心动图，并与危险区锝放射自显影确定。两种方法之间有很好的相关性（r = 0.96，y = 0.91x +1.5，p <0.001，SEE = 3.17）。然而，使用这两种方法对左心室各个水平的风险区域进行比较，显示相关程度存在一些差异，在心尖处拟合最差。为了确定变异的来源，通过在单个节段植入心外膜标记并使用两种方法测量该节段的“风险面积”，在另外6只犬（B组）中最大限度地减少了数据配准引起的误差。当没有配准误差时，两种方法之间的相关性极好（r = 0.99，y = 0.92x +2.6，p <0.001，SEE = 0.55）。总之，使用心肌声学造影可以准确地确定整个左心室以及单个断层切片的急性冠状动脉闭塞后梗死的“危险区域”。这是使用锝放射自显影法进行验证的，这是一种在实验环境中确定“风险区域”的既定方法。
Myocardial contrast echocardiography has been shown recently to accurately assess the “area at risk” for necrosis after acute coronary occlusion in the experimental model. Risk area quantitation, however, has been studied primarily from single tomographic planes. Because the three-dimensional extent of myocardial necrosis depends on the total volume of myocardium at risk, the total left ventricular “area at risk” was determined in 11 dogs (Group A) with either left anterior descending or left circumflex artery occlusion using contrast echocardiography and compared with risk area determined by technetium autoradiography. An excellent correlation was found between the two methods (r = 0.96, y = 0.91x + 1.5, p < 0.001, SEE = 3.17). A comparison of risk area for individual levels of the left ventricle using both methods, however, showed some variation in the degree of correlation, with the poorest fit being apparent at the apex. To identify the source of the variation, errors caused by data registration were minimized in six additional dogs (Group B) by implanting epicardial markers at a single level and measuring “area at risk” at this level using both methods. When no registration error was present, the correlation between the two methods was excellent (r = 0.99, y = 0.92x + 2.6, p < 0.001, SEE = 0.55).In conclusion, the “area at risk” for infarction after acute coronary occlusion can be determined accurately for the entire left ventricle as well as for a single tomographic slice using myocardial contrast echocardiography. This was validated using technetium autoradiography, which is an established method of determining “area at risk” in the experimental setting.