Evaluation Of Two-Dimensional Strain Echo-cardiography For Left Ventricular Myocardial Function Pre And Post Percutaneous Coronary Intervention In Patients With Coronary Artery Disease

Objective:To quantitatively investigate myocardium function of left ventricular (LV) pre and post percutaneous coronary intervention (PCI) by two dimensional strain echo-cardiography (2DSE),then to discuss the clinical value of 2DSE in estimating shortly therapy effect pre and post PCI for patients with coronary artery disease(CHD).Methods:43 cases suspecting CHD underwent coronary angiography (CAG) between March,2010 and december,2010.They were divided into 2 groups based on the extent of stenosis by CAG, that was CHD group (stenosis70-98%) 20 cases and control group (stenosis< 50%) 23 cases. High frame rate two-dimensional echo-cardiography images were recorded from the four-chamber view, two-chamber view and long-axis view of the LV and the LV short-axis views at the levels of mitral annulus, papillary muscle and apex about one to three days before CAG in all patients and one week, three months after PCI in patients with CHD respectively. The LV peak systolic longitudinal, radial, circumferential strain, the basal and apical rotation and the LV torsion of all cases were measured by STI software.Results:1. Before CAG:The outlines of strain-time curves of control group were neat and had a higher wave peak, but those of CHD group were disorderly, the peaks of curves in different segments were low and calm.The peak systolic longitudinal strain of different segments of CHD group were significantly reduced when compared with that of the control group(P<0.05). However, there was no statistical significant difference in the peak systolic radial strain and circumferential strain between CHD groups and control group(P>0.05). The apical LV rotation and the LV torsion were significantly lower in the CHD group than in the control group(P<0.05). but, there was no statistical significant difference in the the basal rotation LV torsion between CHD groups and control group(P>0.05); 2. After CAG and PCI:One week after treatment, the peak of strain of lesion segments have increased slightly, but there was not significant difference in all indicatrixes pre and post PCI(P<0.05);Three months after treatment, the outlines of strain-time curves of ischemic segments trended to be regular and the peaks elevated markedly; The peak systolic longitudinal strain of most segments in the CHD group increased significantly after three months than that of before PCI(P<0.05); The LV apical rotation and torsion were significantly higher than that of before PCI(P<0.05).The peak systolic radial strain, circumferential strain and the basal LV rotation had no significantly improvement pre and post PCI (P>0.05). There was no statistical significant difference in all indicatrixes between CHD groups three months after PCI and control groups(P>0.05).Conclusions:To investigate the strain characteristics pre and post PCI by 2DSE imaging for patients with CHD, then to evaluate the LV myocardium function, in a comprehensive analysis of reflecting myocardial function, the longitudinal strain, rotation and torsion would be more sensitive than radial, circumferential strain to access the improving states myocardial function after PCI in patients with CHD.