■在中期随访期间,关于复苏后心脏骤停[自主循环恢复后(ROSC后)]心肌功能障碍演变的实验研究信息很少。为此,我们在心脏骤停(CA)大鼠模型中评估了不同时间点的左心室(LV)功能和循环心脏生物标志物.
■将大鼠分为两组:对照组和ROSC后大鼠。未经治疗的心室纤颤8分钟,然后进行心肺复苏8分钟。评估了常规和斑点追踪超声心动图(STE)参数和心脏循环生物标志物浓度,在ROSC后3、4、72和96小时。在ROSC后3和4小时,左心室收缩功能严重受损,高敏心肌肌钙蛋白T和N末端心房利钠肽前体(NT-proANP)血浆浓度明显升高,与对照组大鼠相比(全部P<0.0001)。在ROSC后72和96小时,LV射血分数(LVEF)归一化。在96小时,以下变量与对照大鼠有显著差异:早期跨二尖瓣峰值速度,56.8±3.1vs.87.8±3.8cm/s,P<0.0001;二尖瓣晚期峰值速度,50.6±4.7vs.73.7±4.2cm/s,P<0.0001;平均波速,4.6±0.3vs.5.9±0.3cm/s,P<0.0001,整体纵向应变(GLS)-7.5±0.5和vs.-11±1.2%,P<0.01;GLS速率(GLSR)-0.9±0.4和-2.3±0.21/s,P<0.01;NT-proANP浓度,2.5(0.2;6.0)与0.4(0.01;1.0)nmol/L,P<0.01。
■s\'速度,GLS,和GLSR表明,在ROSC后96小时,LV收缩功能仍然受损。这些发现与NT-proANP浓度一致,它仍然很高。LVEF的标准化支持STE的使用,因为它具有更高的灵敏度来监测CA后的心脏功能。需要进一步的研究来提供ROSC后LV舒张功能模式的证据。
UNASSIGNED: There is little information from experimental studies regarding the evolution of post-resuscitation cardiac arrest [post-return of spontaneous circulation (post-ROSC)] myocardial dysfunction during mid-term follow-up. For this purpose, we assessed left ventricular (LV) function and circulating cardiac biomarkers at different time points in a rat model of cardiac arrest (CA).
UNASSIGNED: Rats were divided into two groups: control and post-ROSC rats. Eight minutes of untreated ventricular fibrillation were followed by 8 min of cardiopulmonary resuscitation. Conventional and speckle-tracking echocardiographic (STE) parameters and cardiac circulating biomarkers concentrations were assessed, at 3, 4, 72, and 96 h post-ROSC. At 3 and 4 h post-ROSC, LV systolic function was severely impaired, and high-sensitivity cardiac troponin T and N-terminal pro-atrial natriuretic peptide (NT-proANP) plasma concentrations were significantly increased, compared with control rats (P < 0.0001 for all). At 72 and 96 h post-ROSC, LV ejection fraction (LVEF) normalized. At 96 h, the following variables were significantly different from control rats: early trans-mitral peak velocity, 56.8 ± 3.1 vs. 87.8 ± 3.8 cm/s, P < 0.0001; late trans-mitral peak velocity, 50.6 ± 4.7 vs. 73.7 ± 4.2 cm/s, P < 0.0001; mean s\' wave velocity, 4.6 ± 0.3 vs. 5.9 ± 0.3 cm/s, P < 0.0001, global longitudinal strain (GLS) -7.5 ± 0.5 and vs. -11 ± 1.2%, P < 0.01; GLS rate (GLSR) -0.9 ± 0.4 and -2.3 ± 0.2 1/s, P < 0.01; and NT-proANP concentration, 2.5 (0.2; 6.0) vs. 0.4 (0.01; 1.0) nmol/L, P < 0.01.
UNASSIGNED: s\' velocity, GLS, and GLSR indicated that LV systolic function was still impaired 96 h post-ROSC. These findings agree with NT-proANP concentrations, which continue to be high. Normalization of LVEF supports the use of STE for its greater sensitivity for monitoring post-CA cardiac function. Further investigations are needed to provide evidence of the post-ROSC LV diastolic function pattern.