Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/14363
標題: 以斑點追蹤心臟超音波評估二尖瓣逆流瑪爾濟斯犬隻左心室旋轉參數之差異
Evaluation of Left Ventricular Rotation Parameters by Speckle Tracking Echocardiography in Maltese Dogs with Mitral Regurgitation
作者: 林倡弘
Lin, Chang-Hong
關鍵字: 斑點追蹤心臟超音波;Ventricular Rotation;旋轉;螺旋運動;二尖瓣逆流;twist;speckle tracking
出版社: 獸醫學系暨研究所
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摘要: 
正常狀況下,由心尖往上看,心臟收縮期時,左心室心尖部會朝逆時針旋轉,心基部朝順時針旋轉,而形成螺旋運動將血液「擰」出;這種螺旋運動對整個左心功能的維持占很重要的角色。文獻曾指出,於動物實驗中,左心室螺旋運動的異常,代表左心室代償不能的狀況。最新發展的斑點追蹤心臟超音波技術 (speckle tracking image, STE),可以提供一種非侵入性、無角度限制的方法來測心臟的旋轉運動,人類臨床和動物試驗上也都證實其準確性是可以和核磁共振 (magnetic resonance imaging , MRI)相比的;但此技術於小動物臨床上的資料,相對來說是缺乏的。我們使用這種技術來評估二尖瓣逆流的瑪爾濟斯犬隻,其二尖瓣逆流是否會造成心肌運動性的異常、STE各項指數和左心室代償和重塑的相關性,以及此項技術於小動物臨床上的應用性。21隻健康瑪爾濟斯犬為對照組,另31隻實驗組為二尖瓣逆流犬依照美國獸醫內科醫學會分類,依序分為MR1組 (10隻)、MR2 (12隻)和MR3 (9隻)。所有犬隻皆進行傳統心臟超音波、組織都卜勒和STE檢查。結果顯示心基部旋轉角度於MR3組會明顯減少;放射狀和環狀應變量於MR3組明顯會延遲,這些變化應該和左心室心肌代償不能較有關係。但心尖部的旋轉運動和左心室整體螺旋運動角度上並未發現明顯異常,而且心尖部影像品質較難達到可測量的標準。依上述結果,臨床使用STE偵測二尖瓣逆流的嚴重程度,應該是可行的,可當作另一個輔助標準;但於左心室螺旋運動的監測,則會受限於心尖部影像品質的關係,於臨床上的應用則需要再進一步考慮。
URI: http://hdl.handle.net/11455/14363
其他識別: U0005-0508201211304400
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