二维斑点追踪技术对柔红霉素药物急性期心肌损伤的相关性

目的 应用二维斑点追踪技术(STI)研究柔红霉素致滇南小耳猪急性期心肌损伤的左心室应变特点及心肌病理改变.方法 选取滇南小耳猪6只,常规给予麻醉后连接心电图电极,予柔红霉素进行静脉推注,制成心脏毒性急性期动物模型,并于给药前和给药后3d进行心脏超声数据获取、抽血进行cTnT测定,处死后进行心脏、肝脏的病理检测.超声参数...

Two-dimensional Speckle Tracking Technology in the Study of Acute Myocardial Injury Caused by Anthracyclines

  Objective  To study the characteristics of left ventricular strain and myocardial pathological changes in acute myocardial injury induced by anthracyclines in Diannan small-ear pigs.   Methods  Six small-eared pigs from southern Yunnan were selected. After routine anesthesia, electrocardiogram electrodes were connected, daunorubicin was injected intravenously, and an animal model of acute cardiotoxicity was made. The echocardiography was performed before and three days after the administration. Data acquisition, blood draw for cTnT determination, and pathological examination of heart and liver after execution. Obtain two-dimensional echocardiography of ultrasound parameters to measure the left ventricular end-diastolic diameter （LVDd）, peak E velocity, peak A velocity and E/A ratio of blood flow during diastole of the mitral valve, and automatically calculate the overall left ventricle longitudinal strain GLS and left ventricular stratified longitudinal strain parameters were compared and analyzed.   Results  There was no statistical difference in left ventricular end diastolic diameter （LVDd）, left ventricular end systolic diameter （LVDs）, ventricular septal end diastolic thickness （IVSd） and left ventricular posterior wall end diastolic thickness （PWd） and EF between before and after administration of acute myocardial injury （P > 0.05）. Although the serum cTnT concentration gradually increased after administration, it remained within the normal range, and there was no significant statistical difference from the value measured before administration. The liver and myocardial cells showed edema and congestion to varying degrees, and hyaloid and mucus-like changes appeared in the endocardium （P > 0.05）. There were statistical differences in the overall GLS of the left ventricle and the endocardial layer before and after the administration, but there was no statistical difference in the GLS of the middle layer and the epicardial layer （P < 0.05）.   Conclusions  Large doses of anthracyclines can cause acute myocardial damage to the myocardium, and the pathological results support myocardial cell damage. At the same time, the conventional measurement of the size of the heart cavity and EF cannot reflect the functional damage of the myocardium in time. The use of 2D-STI technology to measure the longitudinal strain of the left ventricle and the strain of the center of the endocardium layer can be more sensitive to find applications than traditional cardiac ultrasound data such as EF. Cardiotoxicity after anthracyclines.