Endomyocardial radial strain rate imaging during dobutamine stress echocardiography for the evaluation of contractile reserve in patients with dilated cardiomyopathy
Endomyocardial radial strain rate imaging during dobutamine stress echocardiography for the evaluation of contractile reserve in patients with dilated cardiomyopathy
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DOI：
10.1002/jcu.22376
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发表时间：
2016-11-01
影响因子：
0.9
通讯作者：
Murohara，Toyoaki
中科院分区：
文献类型：
--
作者：
Minoshima，Makoto;Noda，Akiko;Murohara，Toyoaki
目的扩张型心肌病(DCM)患者的心肌收缩储备与临床预后密切相关。应用组织多普勒应变率成像技术结合多巴酚丁胺负荷超声心动图评价DCM患者的心肌收缩储备功能。方法对20例DCM患者在多巴酚丁胺负荷时同时进行超声心动图检查和左心导管检查，并与31例对照组进行比较。多巴酚丁胺开始剂量为5μg/kg/m in，持续5 m in，然后以10μg/kg/m in静注。以超声心动图测量的心内膜心肌径向峰值应变(ɛ)、收缩应变率(SRsys)和导管法测得的左室压最大一阶导数(LVdp/dtmax)作为收缩功能的指标。结果扩张型心肌病组的ɛ和SRsys明显小于对照组。10ming/kg/μ时，LVdp/dtmax、LVdp/dtmax、LVdp/dtmax和SRsys均显著高于基础值。SRsys的变化与LV dp/dtmax的变化呈正相关。结论DCM多巴酚丁胺负荷时的应变率成像可作为评价心肌收缩储备功能的无创性指标，并可深入了解左心室收缩功能障碍。©2016 Wiley期刊，Inc.J临床超声44：555-560,2016
PurposeMyocardial contractile reserve is associated with clinical prognosis in patients with dilated cardiomyopathy (DCM). We assessed myocardial contractile reserve using tissue Doppler strain rate imaging with dobutamine stress echocardiography in DCM patients.MethodsSimultaneous echocardiography and left ventricular (LV) catheterization during dobutamine stress were performed in 20 patients with DCM, and echocardiography was performed in 31 control subjects. Dobutamine was infused at a starting dose of 5 μg/kg/min for 5 minutes and then at 10 μg/kg/min. Peak endomyocardial radial strain (ɛ) and systolic strain rate (SRsys) measured with echocardiography and the maximum first derivative of LV pressure (LV dP/dtmax) derived from catheterization were used as indices of contractility. Their percentage change from baseline to the dose of 10 μg/kg/min was calculated.ResultsThe ɛ and SRsyswere significantly smaller in DCM patients than in controls. The LV dP/dtmax, ɛ, and SRsyswere significantly higher at the dose of 10 μg/kg/min than at baseline. The percentage change in SRsyswas significantly correlated with the percentage change in LV dP/dtmax.ConclusionsStrain rate imaging during dobutamine stress in DCM might prove noninvasively informative for the evaluation of myocardial contractile reserve and provide insight into LV systolic dysfunction. © 2016 Wiley Periodicals, Inc.J Clin Ultrasound44:555–560, 2016