经静脉心肌造影对犬冠状动脉阻断后存活心肌评价的实验研究

目的:探讨经静脉心肌造影(MCE)对犬冠状动脉阻断后存活心肌判定的价值。方法:应用自制声学造影剂,对12条犬于冠状动脉阻断即刻、阻断后1h、4h和再灌注后1h进行经静脉心肌造影研究。结果:当冠状动脉阻断后,所有犬阻断的冠状动脉供血区心肌出现节段性的灌注缺损。阻断即刻与1h的灌注缺损区面积无明显差异,而阻断4h后灌注缺损面积较前两者变小,在阻断早期灌注缺损区域部分变为正常或灌注减低区。灌注减低区对应的氯化三苯四氮唑染色显示为存活心肌。结论:冠状动脉阻断一定时间后MCE可以准确判定存活心肌。

Assessment of viable myocardium after coronary artery occlusion using myocardial contrast echocardiography

Objective:To discuss the value of the assessment of viable myocardium after coronary artery occlusion by using myocardial contrast echocardiography(MCE).Methods:Twelve opened-chest mongrel dogs underwent MCE with intravenous injection of self-made contrast agent immediately,1 hour,and 4 hours after coronary artery occlusion and 1 hour after reperfusion.Results:The segmental perfusion defects were found in all dogs after coronary artery occlusion.There was no significant difference in the perfusion defect size in dogs immediately and 1 hour after coronary artery occlusion,but the perfusion defect size 4 hours after coronary artery occlusion was smaller than that immediately or 1 hour after coronary artery occlusion.The perfusion defect area became normal or diminished perfusion area.The myocardium in the diminished perfusion area was viable,which was confirmed by triphenyltetrazolium chloride(TTC)staining.Conclusion:The viable myocardium can be assessed correctly with MCE after coronary artery occlusion.