Norrild Kathrine, Pedersen Troels Fogh, Sloth Erik
Department of Anaesthesiology, Skejby Hospital, Aarhus University, Copenhagen, Denmark.
J Cardiothorac Vasc Anesth. 2007 Jun;21(3):367-70. doi: 10.1053/j.jvca.2006.08.012. Epub 2006 Dec 8.
Tissue Doppler imaging is an evolving ultrasound technology that, compared with traditional echocardiography, promises reduced subjectivity in the assessment of myocardial performance and contributes new information on myocardial function. The aim of this study was to evaluate the feasibility of transesophageal tissue Doppler imaging in the setting of aortic valve replacement.
Feasibility study.
Aarhus University Hospital, Denmark.
Twelve patients with isolated aortic valve stenosis or combined ischemic cardiomyopathy and aortic valve stenosis scheduled for elective aortic valve replacement were included.
Transgastric short-axis recordings of the left ventricular anterior wall were performed using Vivid-7 technology (GE Healthcare, Horten, Norway) with activated tissue Doppler imaging before sternotomy, at intervals during progressive withdrawal of cardiopulmonary bypass, and within 1 hour after transfer to the postoperative care unit. Data were postprocessed for assessment of systolic radial function with the tissue Doppler modalities, tissue velocity, end-systolic strain rate, and strain by using dedicated software.
Accurate tissue Doppler data were obtained for all patients at baseline and postoperatively. During the gradual loading of the left ventricle, velocity measurements were all obtained accurately, whereas 8% to 25 % of strain and strain-rate measurements were considered unreliable. Immediately after cardioplegia, 33% to 58% of measurements were unreliable.
Transesophageal tissue Doppler is feasible in the intraoperative setting, although unreliable data acquisition occurs during cardiopulmonary bypass. Tissue Doppler is a promising quantitative tool for monitoring of myocardial function within minutes and may also reveal new information on myocardial function in patients undergoing thoracic surgery.
组织多普勒成像技术是一种不断发展的超声技术，与传统超声心动图相比，它有望降低心肌性能评估中的主观性，并提供有关心肌功能的新信息。本研究的目的是评估经食管组织多普勒成像在主动脉瓣置换术中的可行性。
可行性研究。
丹麦奥胡斯大学医院。
纳入12例计划择期行主动脉瓣置换术的单纯主动脉瓣狭窄或合并缺血性心肌病及主动脉瓣狭窄患者。
在胸骨切开术前、体外循环逐渐撤离期间以及转入术后监护病房后1小时内，使用Vivid-7技术（通用电气医疗集团，挪威霍滕）激活组织多普勒成像，进行经胃左心室前壁短轴记录。使用专用软件对数据进行后处理，以评估组织多普勒模式下的收缩期径向功能、组织速度、收缩末期应变率和应变。
所有患者在基线和术后均获得了准确的组织多普勒数据。在左心室逐渐加载过程中，速度测量均准确获得，而应变和应变率测量中有8%至25%被认为不可靠。心脏停搏后立即进行的测量中有33%至58%不可靠。
经食管组织多普勒成像在术中是可行的，尽管在体外循环期间会出现数据采集不可靠的情况。组织多普勒是一种有前景的定量工具，可在数分钟内监测心肌功能，还可能揭示胸外科手术患者心肌功能的新信息。
