Myocardial strain/stress changes identified by echocardiography may reveal early sepsis-induced myocardial dysfunction.
Myocardial strain/stress changes identified by echocardiography may reveal early sepsis-induced myocardial dysfunction.
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DOI：
10.1177/0300060517737434
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Liu D
中科院分区：
文献类型：
--
作者：
Wang X;Su L;Yang R;Zhang H;Liu D
采用应变/负荷超声心动图对脓毒症引起的心肌功能障碍（SIMD）进行早期评估。采用静脉注射脂多糖（LPS，2 mg/kg）建立犬SIMD模型。包括13只狗，包括LPS处理的SIMD组（n = 7）和盐水对照组（n = 6）。在不同的时间点使用心脏测量（包括血流动力学和超声心动图）评估SIMD。脓毒症组在所有时间点的收缩压、径向心室壁应力和环形心室壁应力（WSsc）均显著低于对照组。Logistic回归分析显示，左室前后壁和底壁应力率与左室收缩期室壁强度呈负相关。与此相反，平均速度的圆周纤维缩短（mVCF）或心率调整的mVCF（RVCF）和WSSC之间呈正相关。使用回归方程，预测值的mVCF和RVCF在脓毒症动物显著高于测量值在4- 5-和6小时的时间点。这些发现将进一步了解脓毒症早期SIMD的病理生理变化，并表明应变率可能反映心肌收缩力的性质。
To perform early assessment of sepsis-induced myocardial dysfunction (SIMD) using strain/stress echocardiography. A canine model of SIMD was established using intravenous injection of lipopolysaccharide (LPS, 2 mg/kg). Thirteen dogs were included, comprising an LPS-treated SIMD group (n = 7) and saline control group (n = 6). SIMD was assessed at various time-points using cardiac measurements including haemodynamics and echocardiography. Systolic and radial ventricular wall stress and circular ventricular wall stress (WSsc) were significantly lower in the sepsis group versus the control group at all time-points. Logistic regression analysis revealed an inverse correlation between stress rate of the front-posterior and bottom wall and left ventricle systolic wall strength. In contrast, a positive correlation was found between the mean velocity of circumferential fibre shortening (mVCF) or heart rate-adjusted mVCF (RVCF) and WSsc. Using regression equations, predicted values for mVCF and RVCF in animals with sepsis were significantly higher than measured values at 4- 5- and 6-h time-points. These findings will further the understanding of pathophysiological alterations in SIMD at the early stage of sepsis, and suggest that strain rate may reflect the nature of myocardial contractility.