Left Ventricular Sistolic And Diastolic Function Assessed By Speckle Tracking Imaging In Patients With Coronary Artery Disease

Objective:To discuss the value of using speckle tracking imaging(STI) to measure the mitral annular movement assessment of left ventricular systolic and diastolic function in patients with coronary artery disease (CAD)Methods:1. All of the subjects were underwent coronary angiography(CAG).They were grouped according to the CAG findings as follows:CAD group:80 coronary artery disease patients were enrolled, coronary angiography results were at least one major coronary artery stenosis≥50%.acute myocardial infarction group:included 40 patients;angina pectoris group:included 40 patients. In accordance with echocardiogr-aphy,clinical symptom and myocardium creatase results, control group:40 patients with normal coronary artery were enrolled.2. A ultrasound system Philips iE33 equipped with Q-Lab 6.0 software. All of the subjects accepted a standard echocardiography test. High frame rate(>60 frame/s) two dimensional images were recorded from the apical four-chamber view, long-axis view and two-chamber view of the left ventricular respectively, septal and lateral from apical four-chamber view,anteroseptum and posterior from apical long-axis view, anterior and inferior from apical two-chamber view were adopted.Then we traced the mitral annular movement curve with the tissue motion annulus displacement software and measured the mitral annular systolic peak displacement(Ds) and peak velocity(Vs), early diastolic peak displacement(De) and peak velocity(Ve).We caculated the mean Ds,Vs,De, Ve, of the six sites(SMD,SMV,EMD,EMV).3. The system was switched to tissue Doppler imaging (TDI) velocity mode. Apical four-chamber view was dispayed within the lateral,septal sites of the mitral annulus. Systolic peak velocity (Sa), early diastolic peak velocity(Ea),late diastolic peak velocity (Aa)were measured,and the Ea/Aa ratio was calculated.To measure left ventricular ejection fraction(LVEF) in the ultrasonic two dimensional apical four-chamber view and two-chamber view.All dada were analyzed using a standard statistical software program SPSS for Windows,Version 11.5.Results:1. The age,gender, body mass index (BMI),heart rate,among all the subjects showed no significantly different in the three groups (p>0.05);the left atrial and left ventricular of the three groups were progressively larger from the control group to the angina pectoris group and to the acute myocardial infarction group (p<0.01). LVEF of the three groups were progressively declined from the control group to the angina pectoris group and to the acute myocardial infarction group (p<0.01).2. Compared with the control group, the CAD patients had significantly reduced SMD and SMV, EMD and EMV, Ea, Sa and Ea/Aa of the lateral (p<0.01).3. Compared with the angina pectoris group, SMD and SMV, EMD and EMV, Ea and Sa of the acute myocardial infarction group were significantly reduced.4. SMD and SMV were correlated with LYEF(r=0.615, p<0.01; r=0.603, p<0.01), Sa of septal and lateral was correlated with LVEF(r=0.424,p<0.01;r=0.379, p<0.01) in control group and CAD group.Conclusions:1. Compared with the control group, the CAD group had significantly reduced SMD and SMV,The CAD patients's left ventricular systolic function had been decreased, STI measured SMD and SMV can quantitatively assess of left ventricular systolic function in patients with coronary artery disease.2. Compared with the control group, the CAD group had significantly reduced EMD and EMV,The CAD patients's left ventricular diastolic function had been decreased, STI measured EMD and EMV can quantitatively assess of left ventricular diastolic function in patients with coronary artery disease.3. STI to measure the mitral annular movement can be used as a new modality for evaluating left ventricular systolic and diastolic function in patients with coronary artery disease noninvasively and quantitatively.