Assessment Of Left Ventricular Systolic Function And Synchrony In Patients With Coronary Artery Disease By Two-dimensional Speckle Tracking Technology

Background Coronary heart disease(CHD) has been becoming a increasing frequentlyoccurring and commonly encountered disease. With the increasing trend in domestic morbidity and disability rate, early detection and diagnosis has important implications for the treatment and prognosis of the disease. Echocardiography for its non-invasive,convenient, economical, etc, has become one of the most important means of checking for heart disease. Two-dimensional speckle tracking imaging(2DSTI) technology can track the spatial trajectory of the endomyocardial spots automatically while there doesn’t exist any angular dependence. It not only has a good repeatability and a high temporal resolution but also less affected by surrounding myocardial tissue motion, as can evaluate ventricular myocardial strain and myocardial systolic synchrony accurately.Objective To evaluate left ventricular myocardial strain and myocardial systolic synchrony in patients with different degrees of coronary stenosis by two-dimensional speckle tracking technology(2DSTI).Methods 109 cases of coronary heart disease patients received conventional twodimensional ultrasound and speckle tracking technology. According to the results of angiography divided into two groups, negative angiographic results as a control group and coronary heart disease group, while according to the Gensini score of coronary heart disease group was divided into three subgroups, mild disease group(<25 points), moderate disease group(25~50 points), and severe disease group( > 50 points). The images of high-frequency two-dimensional were analysed by CMQ software in the offline. Left ventricular global longitudinal strain(GLS) and left ventricular global circumferential strain(GCS) were measured.Simultaneous the time to minimal systolic longitudinal,circumferential strain(Tssl,Tssc) were measured from the start point of QRS wave of electrocardiogram. Calculated for 16 segments of the left ventricular longitudinal, circumferential peak time standard deviation(Tssl-SD, Tssc-SD) and a longitudinal, circumferential peak maximum time difference(Tssl-Diff, Tssc-Diff),which were served as systolic asynchrony indexes.Results 1. Compared with the control group, coronary heart disease group of age,systolic blood pressure, diastolic blood pressure, body mass index(BMI), heart rate, E/A was no statistically significant difference(P > 0.05);while LA increased(P <0.05);2. Compared with the control group, coronary heart disease each group GLS, GCS was lower than the control group(P < 0.05). With increases of Gensini, GLS and GCS overall trends show progressive decrease, while GCS index in mild disease group and moderate disease group was no statistically significant difference(P>0.05).3.Compared with the control group, the severe disease group Tssl-SD and Tssl-Diff significantly increased(P<0.01); moderate disease group Tssl-SD and Tssl-diff increased(P<0.05); mild disease group Tssl-SD and Tssl-Diff was no statistically significant(P > 0.05). Tssc-SD and Tssc-Diff between the two groups was no statistically significant(P>0.05).4.The correlation analysis of left ventricular systolic synchrony and ejection fraction in coronary heart disease group showed that, Tssl-SD, Tssl-Diff negative correlation with LVEF.Conclusion 1. 2DSTI can accurately evaluate coronary artery disease in patients with left ventricular systolic function and synchrony for early diagnosis of coronary heart disease patients, selection of treatment regimen and reduce the incidence of cardiovascular events provides a noninvasive examination method.2. Left ventricular systolic function in patients with CHD aggravate with the severity of coronary artery disease.3. Dyssynchrony index increase with the decrease of the CHD patients’ ejection fraction.The synchronization degrade between the myocardial contraction and the mechanical contraction, as shows close correlation.