Hardziyenka Maxim, Campian Maria E, de Bruin-Bon H A C M Rianne, Michel Martin C, Tan Hanno L
Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
J Am Soc Echocardiogr. 2006 Oct;19(10):1272-9. doi: 10.1016/j.echo.2006.04.036.
The temporal relations between the onset of echocardiographic changes and clinical diagnosis of right ventricular (RV) failure are unresolved. We have characterized such relations in a rat monocrotaline (MCT) model of RV failure.
Eight-week-old male Wistar rats were injected with MCT (60 mg/kg) or vehicle and underwent serial echocardiography. RV free-wall thickness (RVWT), pulmonary artery acceleration time normalized to cycle length (PAAT/CL), RV end-diastolic diameter (RVEDD), and tricuspid annular plane systolic excursion (TAPSE) were measured.
Significant differences in echocardiographic parameters between MCT-treated and control rats were found as early as 14 days before RV failure for RVWT, 10 days for PAAT/CL, and 7 days for RVEDD and TAPSE. The time intervals between the onset of changes in RVWT, PAAT/CL, RVEDD, and TAPSE and diagnosis of RV failure were 11.3 +/- 0.8, 10.9 +/- 0.7, 6.5 +/- 0.5, and 5.4 +/- 0.7 days, respectively. The sequence of echocardiographic changes was consistent in all animals during development of RV failure.
Pulmonary hypertension (assessed by PAAT/CL) and RV free-wall thickening (characterized by RVWT) precede RV dilation and RV systolic dysfunction (measured by RVEDD and TAPSE, respectively). Echocardiographic analysis permits accurate determination of the stage of disease development in MCT-induced RV failure.
超声心动图变化的起始与右心室(RV)衰竭临床诊断之间的时间关系尚未明确。我们在大鼠单氰胺(MCT)诱导的RV衰竭模型中对这种关系进行了特征描述。
给8周龄雄性Wistar大鼠注射MCT(60mg/kg)或赋形剂,并进行系列超声心动图检查。测量右心室游离壁厚度(RVWT)、肺动脉加速时间与心动周期长度的比值(PAAT/CL)、右心室舒张末期直径(RVEDD)和三尖瓣环平面收缩期位移(TAPSE)。
早在RV衰竭前14天,MCT处理组和对照组大鼠的RVWT超声心动图参数就出现显著差异;PAAT/CL在RV衰竭前10天出现差异;RVEDD和TAPSE在RV衰竭前7天出现差异。RVWT、PAAT/CL、RVEDD和TAPSE变化起始至RV衰竭诊断的时间间隔分别为11.3±0.8天、10.9±0.7天、6.5±0.5天和5.4±0.7天。在RV衰竭发展过程中,所有动物的超声心动图变化顺序一致。
肺动脉高压(通过PAAT/CL评估)和右心室游离壁增厚(以RVWT为特征)先于右心室扩张和右心室收缩功能障碍(分别通过RVEDD和TAPSE测量)出现。超声心动图分析能够准确确定MCT诱导的RV衰竭疾病发展阶段。