Caillaud Dominique, Calderon Joachim, Réant Patricia, Lafitte Stéphane, Dos Santos Pierre, Couffinhal Thierry, Roques Xavier, Barandon Laurent
Inserm U 828, Avenue du Haut-Lévêque, 33600 Pessac, France.
Interact Cardiovasc Thorac Surg. 2010 May;10(5):689-93. doi: 10.1510/icvts.2010.232819. Epub 2010 Feb 5.
Despite much progress in the medical management of myocardial ischemia, several problems remain and experimental models help to improve our understanding of the pathophysiology involved in this domain. The ameroid constrictor model is the most widely used to create ischemia but evaluation of patent ischemia is still under debate. In the present study, we describe the potential of a two-dimensional (2D) strain for experimentally evaluating myocardial ischemia in the pig. An ameroid constrictor was placed around the circumflex artery in 30 pigs. Angiography showed 90% stenosis at one and two months. Left ventricular function was moderately altered and associated with mitral valve insufficiency in 30% of cases. Longitudinal and circumference strains were dramatically modified in the ischemic inferior-lateral zone compared to the healthy anterior zone (P<0.01) at one and two months. We correlated these results to myocardial ischemia by using contrast echocardiography, which showed a significant reduction in myocardial perfusion in the ischemic zone compared to the uninjured area, and by using histological analysis. We showed that evaluation of the 2D strain could be an interesting approach for assessing myocardial ischemia after ameroid constrictor implantation. The 2D strain represents a useful tool for the evaluation of experimental models of myocardial ischemia.
尽管在心肌缺血的医学管理方面取得了很大进展，但仍存在一些问题，实验模型有助于增进我们对该领域病理生理学的理解。阿梅罗伊德缩窄器模型是最广泛用于制造缺血的模型，但对持续性缺血的评估仍存在争议。在本研究中，我们描述了二维（2D）应变在实验评估猪心肌缺血中的潜力。在30头猪的回旋支动脉周围放置阿梅罗伊德缩窄器。血管造影显示在1个月和2个月时狭窄率为90%。左心室功能有中度改变，30%的病例伴有二尖瓣关闭不全。与健康的前壁区域相比，在1个月和2个月时，缺血的下外侧区域的纵向和圆周应变有显著改变（P<0.01）。我们通过使用对比超声心动图（其显示缺血区域的心肌灌注与未损伤区域相比显著减少）以及组织学分析，将这些结果与心肌缺血相关联。我们表明，二维应变评估可能是评估阿梅罗伊德缩窄器植入后心肌缺血的一种有趣方法。二维应变是评估心肌缺血实验模型的有用工具。
