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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2017, Vol. 14 ›› Issue (01) : 67 -71. doi: 10.3877/cma.j.issn.1672-6448.2017.01.016

所属专题： 文献；

基础研究

二尖瓣反流连续多普勒频谱评价犬左心室松弛时间常数Tau
孙静1, 范春芝2, 窦健萍3, 温朝阳4,†()   
  1. 1. 710054　西安，武警陕西总队医院心内科
    2. 100020　首都医科大学附属北京朝阳医院超声医学科
    3. 100853　北京，解放军总医院介入超声科
    4. 100048　北京，解放军总医院第一附属医院超声科
  • 收稿日期:2016-04-23 出版日期:2017-01-01
  • 通信作者: 温朝阳
  • 基金资助:
    国家自然科学基金(81141019); 北京市自然科学基金(7172209); 海南省重点科技计划项目(ZDXM2014062); 海南省自然科学基金(813227); 海南省医学科研课题(琼2012PT-73)

Calculation of left ventricular relaxation time constant (Tau) in dogs with mitral regurgitation by continuous-wave Doppler

Jing Sun1, Chunzhi Fan2, Jianping Dou3, Chaoyang Wen4,†()   

  1. 1. Department of Cardiology of Shanxi Municipal Corps Hospital, Xi′an 710054, China
    2. Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
    3. Department of Interventional Ultrasound, Chinese People′s Liberation Army General Hospital, Beijing 100853, China
    4. Department of Ultrasound, the First Affiliated Hospital of Chinese People′s Liberation Army General Hospital, Beijing 100048, China
  • Received:2016-04-23 Published:2017-01-01
  • Corresponding author: Chaoyang Wen
  • About author:
    Corresponding author: Wen Chaoyang, Email:
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孙静, 范春芝, 窦健萍, 温朝阳. 二尖瓣反流连续多普勒频谱评价犬左心室松弛时间常数Tau[J]. 中华医学超声杂志（电子版）, 2017, 14(01): 67-71.

Jing Sun, Chunzhi Fan, Jianping Dou, Chaoyang Wen. Calculation of left ventricular relaxation time constant (Tau) in dogs with mitral regurgitation by continuous-wave Doppler[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(01): 67-71.

目的

探讨采用二尖瓣反流连续多普勒频谱评价左心室松弛时间常数Tau的新方法。

方法

9只健康成年比格犬，超声引导下经颈动脉鞘管采用活检钳钳夹二尖瓣腱索制作犬二尖瓣反流模型；超声引导下，经颈动脉鞘管将三聚氰胺微球溶液注射于左冠状动脉窦内，微栓塞冠状动脉，以左心室舒张末压升高≥5 mmHg（1 mmHg=0.133 kPa）为标准，诱发急性缺血性左心室舒张功能障碍；静脉滴注多巴酚丁胺或盐酸艾司洛尔，改变血流动力学状态。在不同血流动力学状态下，超声采集二尖瓣反流连续多普勒频谱及其原始音频信号，多导生理仪同步记录左心室压力曲线、dP/dt曲线、左心房压力曲线、心电图。Matlab软件处理并形成新的二尖瓣反流频谱（频线刷新速度300 μs）、自动生成包络线、测量频谱减速支中速度分别为1、2、3 m/s的时间t1、t2、t3，代入相应公式计算Tau超声。根据Weiss公式采用导管法测量指标计算Tau导管。采用配对t检验比较Tau导管与Tau超声的差异；采用Pearson相关分析分析Tau导管与Tau超声的相关性。

结果

共获得39个不同血流动力学状态下的反流频谱进行分析。Tau导管为21.03~78.45 ms，平均为（48.76±17.60） ms；Tau超声为21.24~94.60 ms，平均为（49.33±18.79）ms，两者差异无统计学意义（t=0.353，P=0.726）。Pearson相关分析结果显示，Tau导管与Tau超声呈正相关（r=0.85，P<0.01）。

结论

通过测量二尖瓣反流连续多普勒频谱减速支中速度分别为1、2、3 m/s的时间t1、t2、t3，代入相应Tau计算公式即可计算Tau，与导管法比较具有良好相关性。

关键词: 左心室松弛时间常数, 连续多普勒频谱, 二尖脉瓣反流
Objective

To explore the new method for noninvasively measuring the time constant of left ventricular relaxation (Tau) in animals with mitral regurgitation by continuous-wave Doppler.

Methods

The acute ischaemic left diastolic heart failure with mitral regurgitation was produced in 9 dogs. Dobutamine hydrochloride or esmolol hydrochloride had been applied to change the hemodynamic states. In different hemodynamic states, left ventricular pressures, left atrial pressures, curves of dP/dt and continuous-wave mitral regurgitant spectra were synchronously recorded. Doppler spectra were laterly processed through Matlab workstation. Paired t-test was used to compare the difference between Tau-catheter (Tau-c) and Tau-doppler ultrasound (Tau-d), and the correlation between Tau-c and Tau-d was analyzed by Pearson correlation analysis.

Results

Thirty-nine hemodynamic status had been obtained in 9 dogs. Tau-c was 21.03-78.45 ms and the average was (48.76±17.60) ms. Tau-d was 21.24-94.60 ms and the average was (49.33±18.79) ms. There was no significant difference (t=0.353, P=0.726) between Tau-d and Tau-c. The correlation analysis between Tau-d and Tau-c suggested a strong positive relationship with the correlation coefficient (r=0.85, P<0.001).

Conclusions

The dog aortic regurgitation model under ultrasound guidance is less traumatic. The method of inducing left ventricular diastolic dysfunction by repeatedly injecting microspheres into the left coronary sinus is safe and reliable. Choosing three points (t1, 1 m/s; t2, 2 m/s; t3, 3 m/s) in aortic regurgitant velocity spectrum and putting them into the corresponding formula, we can obtain Tau, which had a good correlation with the catheter-derived Tau.

Key words: Continuous Doppler ultrasound, Mitral regurgitation spectrum, Ventricular relaxation time constant
图1 多导生理仪记录相关生理指标曲线。自上而下分别为左心室压力曲线、左心房压力曲线、主动脉压力曲线、左心室压力dP/dt曲线及心电图。左心室-dP/dtmax为-4600.46 mmHg/s，左心室压力为117.56 mmHg（1 mmHg=0.133 kPa），左心房压力为11.86 mmHg，主动脉压力为164.28 mmHg。Tau超声=117.56/4 600.46=0.025 56 s（25.56 ms）
图2 后处理获得的300 μs刷新一次频谱线所形成的二尖瓣反流频谱并自动包络线
图3 Tau导管与Tau超声的相关性
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[1] 范春芝, 孙静, 窦健萍, 郭瑞君, 温朝阳. 主动脉瓣反流连续多普勒频谱评价犬左心室松弛时间常数Tau[J]. 中华医学超声杂志（电子版）, 2017, 14(02): 150-155.
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