猪在各种冠状动脉介入治疗下圆周应变和纵向应变的磁共振成像特征
Magnetic resonance imaging characterization of circumferential and longitudinal strain under various coronary interventions in swine.
作者信息
Suhail Mohammed Sa, Wilson Mark W, Hetts Steven W, Saeed Maythem
机构信息
Mohammed SA Suhail, Mark W Wilson, Steven W Hetts, Maythem Saeed, Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, CA 94107-5705, United States.
出版信息
World J Radiol. 2013 Dec 28;5(12):472-83. doi: 10.4329/wjr.v5.i12.472.
AIM
To compare the acute changes in circumferential and longitudinal strain after exposing a coronary artery to various interventions in swine.
METHODS
Percutaneous balloon angioplasty catheter was guided to location aid device (LAD) under X-ray fluoroscopy to create different patterns of ischemic insults. Pigs (n = 32) were equally divided into 4 groups: controls, 90 min LAD occlusion/reperfusion, LAD microembolization, and combined LAD occlusion/microembolization/reperfusion. Three days after interventions, cine, tagged and viability magnetic resonance imaging (MRI) were acquired to measure and compare left and right circumferential strain, longitudinal strain and myocardial viability, respectively. Measurements were obtained using HARP and semi-automated threshold method and statistically analyzed using unpaired t-test. Myocardial and vascular damage was characterized microscopically.
RESULTS
Coronary microemboli caused greater impairment in l left ventricular (LV) circumferential strain and dyssynchrony than LAD occlusion/reperfusion despite the significant difference in the extent of myocardial damage. Microemboli also caused significant decrease in peak systolic strain rate of remote myocardium and LV dyssynchrony. Cine MRI demonstrated the interaction between LV and right ventricular (RV) at 3 d after interventions. Compensatory increase in RV free wall longitudinal strain was seen in response to all interventions. Viability MRI, histochemical staining and microscopy revealed different patterns of myocardial damage and microvascular obstruction.
CONCLUSION
Cine MRI revealed subtle changes in LV strain caused by various ischemic insults. It also demonstrated the interaction between the right and left ventricles after coronary interventions. Coronary microemboli with and without acute myocardial infarction (AMI) cause complex myocardial injury and ventricular dysfunction that is not replicated in solely AMI.
目的
比较在猪冠状动脉接受各种干预后圆周应变和纵向应变的急性变化。
方法
在X线透视引导下，将经皮球囊血管成形术导管送至左前降支（LAD）定位辅助装置，以制造不同模式的缺血性损伤。猪（n = 32）被平均分为4组：对照组、LAD闭塞/再灌注90分钟组、LAD微栓塞组和LAD闭塞/微栓塞/再灌注联合组。干预后3天，采集电影、标记和存活心肌磁共振成像（MRI），分别测量和比较左右圆周应变、纵向应变和心肌存活情况。使用HARP和半自动阈值法进行测量，并采用非配对t检验进行统计学分析。通过显微镜观察心肌和血管损伤情况。
结果
尽管心肌损伤程度存在显著差异，但冠状动脉微栓塞比LAD闭塞/再灌注对左心室（LV）圆周应变和不同步性的损害更大。微栓塞还导致远隔心肌的收缩期峰值应变率显著降低和LV不同步性增加。电影MRI显示了干预后3天LV与右心室（RV）之间的相互作用。在所有干预后，均可见RV游离壁纵向应变的代偿性增加。存活心肌MRI、组织化学染色和显微镜检查显示了不同模式的心肌损伤和微血管阻塞。
结论
电影MRI揭示了各种缺血性损伤引起的LV应变细微变化。它还展示了冠状动脉干预后左右心室之间的相互作用。伴有和不伴有急性心肌梗死（AMI）的冠状动脉微栓塞会导致复杂的心肌损伤和心室功能障碍，这在单纯AMI中不会出现。
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