Development of real-time two-dimensional ultrasonic myocardial tissue characterization to assess myocardial molecular characteristics.

我们阐明了超声心肌组织定征指数在动物实验中能很好地反映心肌分子特征和心肌纤维化。一项对心肌梗死患者的临床研究表明，超声指数与心肌放射性核素心肌显像评估的存活心肌相关。另外，穿透性心肌梗死患者与非穿透性心肌梗死患者各指标的跨壁变化趋势也不同。一项对扩张型心肌病患者的研究表明，75%的患者在安静时有异常的指标，并且安静时的指标与心肌组织学评估的心肌纤维化程度相关。在静息指标无异常的患者中，与正常人相比，这些指标对多巴酚丁胺负荷试验的反应异常。目前的结果表明，超声心肌组织定征在无创和经济有效地评估心肌存活和纤维化程度方面是有用的，而且它的临床应用可能通过结合一些负荷试验而得到加强。未来的研究仍有必要确定其在心血管疾病的诊断、治疗策略的确定、治疗效果的评估和预后预测方面的临床应用价值。

We clarified that indexes derived from ultrasonic myocardial tissue characterization well reflected myocardial molecular characteristics and myocardial fibrosis in animal studies. A clinical study with patients with myocardial infarction has demonstrated that the ultrasonic indexes correlated with myocardial viability assessed with myocardial scintigraphy. In addition, the transmural trend of the indexes was different between patients with transmural myocardial infarction and those with non-transmural infarction. A study with patients with dilated cardiomyopathy showed that 75% of the patients had abnormal indexes at rest, and that the indexes at rest correlated with the degree of myocardial fibrosis assessed by myocardial histology. In the patients whose indexes at rest were not abnormal, the indexes provided abnormal responses to dobutamine stress test as compared with normal subjects. The current results suggest that ultrasonic myocardial tissue characterization is useful in non-invasive and cost-effective assessment of myocardial viability and the degree of fibrosis, ad that its clinical utility is likely to be enhanced by a combination with some stress tests. Future studies remain necessary to establish its clinical utility in diagnosis of cardiovascular disease, determination of therapeutic strategy, assessment of effects of therapy and prediction of prognosis.