ESTIMATION OF PERIOPERATIVE CARDIAC FUNCTION FOLLOWING PEDIATRIC CARDIAC SURGERY USING NONINVASIVE MEASUREMENT OF HIGH FREQUENCY QRS POTENTIALS

使用高频 QRS 电位的无创测量来估计小儿心脏手术后的围手术期心脏功能

• 批准号: 10671239
• 负责人: ATSUMI Naotaka
• 金额: $ 1.86万
• 依托单位: Department of Surgery, Institute of Clinical Medicine, University of Tsukuba
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10671239/
• 关键词: high frequency QRS potentials; pediatric cardiac surgery; ischemic reperfusion; myocardial injury; cardiac function; 心筋虚血; 加算平均心電図; 左室内圧-容積関係; 心収縮力

This study seeks to identify a new marker of intraoperative myocardial injury and perioperative cardiac function following pediatric cardiac surgery using high frequency QRS potentials.1) High frequency QRS potentials and perioperative myocardial injury following cardioplegic arrest in pediatric cardiac surgery : Signal-averaged electrocardiograms were recorded during open heart operation in 14 pediatric patients. The high frequency QRS potentials decreased at early reperfusion following cardioplegic arrest and then returned to preischemic levels. The recovery time of high frequency QRS potentials significantly correlated with arrest time and the post operative CK-MB values. The results suggest that myocardial injury in pediatric cardiac surgery can be assessed by changes in the high frequency ECG signals of the QRS complex.2) High frequency QRS potentials and the cardiac function. influence of hypoventilation : The changes in high frequency QRS potentials (RMS) and pressure volume relationship were studied in rat during hypoventilation. Emax, PRSW and RMS decreased during hypoventilation and returned during normal ventilation. There were good correlation between %RMS and %PRSW. The results suggest that decrease in cardiac function can be assessed by changes in RMS.3) High frequency QRS potentials and the cardiac function. isolated rat heart of Langendorff perfusion : The changes in high frequency QRS potentials (RMS) and cardiac function were studied in isolated rat heart of Langendorff perfusion during post ischemic reperfusion period. Left ventricular dp/dt, heart rate, rate-pressure-product and RMS decreased at early reperfusion following cardioplegic arrest and then returned to preischemic levels. The results suggest that the recovery of cardiac function after post ischemic reperfusion period can be assessed by changes in RMS.

本研究旨在利用高频QRS电位确定小儿心脏手术后术中心肌损伤和围术期心功能的新标志物。1）小儿心脏手术中心脏停搏后高频QRS电位和围术期心肌损伤：在14例小儿心脏直视手术中记录信号平均心电图。高频QRS电位在心脏停搏后再灌注早期下降，然后恢复到缺血前水平。高频QRS电位恢复时间与停搏时间及术后CK-MB值显著相关。结果提示，通过QRS波群高频心电图信号的变化，可以评估小儿心脏手术中心肌损伤的程度。2）高频QRS电位与心功能。换气不足的影响：本文研究了大鼠肺通气不足时高频QRS电位（RMS）和压力-容积关系的变化。Emax、PRSW和RMS在低通气时降低，在正常通气时恢复。%RMS和%PRSW之间有良好的相关性。结果提示，心功能下降可通过RMS的变化来评估。3）高频QRS电位与心功能。Langendorff灌流的离体大鼠心脏：采用Langendorff灌流的离体大鼠心脏，观察缺血再灌注后高频QRS电位（RMS）和心功能的变化。心脏停搏后再灌注早期，左室dp/dt、心率、心率-血压乘积和RMS下降，然后恢复到缺血前水平。结果提示，RMS的变化可作为评价缺血再灌注后心功能恢复的指标。

项目成果

Abe M.,Atsumi N.et al.: "High frequency QRS potentials reflect myocardial injury following cardioplegic arrest in pediatric cardiac surgery"Pediatric Cardiology. (in preparation).

Abe M.、Atsumi N.等人：“高频 QRS 电位反映小儿心脏手术中心脏停搏后的心肌损伤”小儿心脏病学。

Masakazu Abe, Naotaka Atsumi, Shounosuke Matsushita, Toshio Mitsui.: "High-frequency QRS potentials reflect myocardial injury following cardioplegic arrest in pediatric cardiac surgery"Pediatric Cardiology : in preparation.

Masakazu Abe、Naotaka Atsumi、Shounosuke Matsushita、Toshio Mitsui.：“高频 QRS 电位反映小儿心脏手术中心脏停搏后的心肌损伤”小儿心脏病学：准备中。