Assessment Of Left Ventricular Function In Patients With Coronary Heart Disease By Using Speckle Tracking Imaging To Measure The Mitral Annular Movement

Part Ⅰ : Assessment of left ventricular systolic function in patients with coronary heart disease by using speckle tracking imaging to measure the mitral annular systolic movementObjective: Measuring the mitral annular systolic movement to assess the left ventricular systolic function in patients with coronary heart disease(CHD) by speckle tracking imaging(STI).Methods: STI was performed on 30 patients with CHD(group CHD) and 30 healthy subjects(control group).To obtain such parameters as maximal systolic displacement(S)of septal,lateral,anterior and inferior mitral annulus(S-sep,S-lat,S-ant,S-inf),systolic displacement of the middle point(Mid) on apical four/two chamber view(AP4-Mid,AP2-Mid),their ratio to the length of left ventricle at end-diastolic(AP4-Mid%,AP2-Mid%) and the time to peak systolic displacement(T) of the four points of mitral annulus(T-sep,T-lat,T-ant,T-inf).Left ventricular ejection fraction(LVEF) were measured by biplane Simpson methods.Results were analyzed using SPSS18.0 statistical software.RESULTS:Compared with control group, S-sep,S-lat,S-ant,S-inf, AP4-Mid, AP2-Mid,AP4-Mid%,AP2-Mid% and the mean of S,Mid,Mid% were decreased significantly(P<0.01 for all),T-sep,T-lat,T-ant,T-inf and the mean of T were increased significantly(P<0.05 or P<0.01) in group CHD.The mean of S, the mean of Mid,the mean of Mid%of all the people correlated well with LVEF(r=0.807,P<0.01;r=0.796,P<0.01;r=0.822,P<0.01);the mean of T also correlated with LVEF(r=-0.433;P<0.01).The sensitivity to diagnose CHD by the mean of S, the mean of Mid,the mean of Mid% were76.7%,73.3%,73.3%,and the specificity were 80.0%,86.7%,73.3%,respectively.Conclusion: The mitral annular systolic movement were changed in patients with CHD.STI can conveniently and sensitively diagnose CHD,and accurately assess left ventricular systolic function in patients with CHD.Part Ⅱ :Using speckle tracking imaging measure the mitral annular diastolic movement of patients with coronary heart diseaseObjective: To explore the value in diagnosing coronary heart disease(CHD)by using speckle tracking imaging(STI) to measure the mitral annular diastolic movementMethods: Twenty-seven CHD patients(group CHD) confirmed by coronary angiography and thirty age-matched normal controls were enrolled in this study. The parameters were obtained by STI which lasted at least three consecutive cardiac cycles:early diastolic displacement(De) and late diastolic displacement(Da) of the four points of mitral annulus,Results were analyzed using SPSS18.0 statistical software.Results: Compared with control group, the De of four points and the mean of De were decreased significantly(all P < 0.01), the Da of lateral, anterior and inferior mitral annulus, the mean of Da of four points(P<0.05 or P<0.01).But the difference of A of septal mitral annulus were no significant between control group and group CAD(P>0.05).The sensitivity to diagnose CHD by the mean of De, the mean of Da were92.6%,92.6%,and the specificity were 86.7%、56.7%,respectively.Conclusion: The mitral annular diastolic movement were changed in patients with CHD.STI has a value in diagnosing CHD and assess left ventricular diastolic function.