Evaluation Of The Left Ventricular Function In Patients With Different Degrees Of Coronary Artery Stenosis Using 2D Speckle Tracking Imaging

Objective: Coronary heart disease is a serious threat to life in clinical diseases of the cardiovascular system.The incidence in the crowd is high and showing an upward trend year by year.Coronary heart disease can lead to left ventricular systolic function in patients with reduced and even death.In addition,it can make a serious decline in people’s quality of life.This research aims to evaluate the left ventricular function in patients with different degrees of coronary artery stenosis when there are no motion abnormalities and the normal range of ejection fraction by 2D speckle tracking imaging.Compared with the results of coronary angiography,reliable and effective parameters and cutoff values were obtained to explore the feasibility and clinical significance.Methods: We enroll 146 cases of patients with suspected coronary artery disease which in Q ingdao University Affiliated hospital outpatient or hospitalization.According to the criteria,excluding criteria and Judkins coronary angiography(C AG)results,including mild coronary artery stenosis 29 cases,moderate coronary artery stenosis group 37 cases,32 cases of severe coronary artery stenosis group and 48 cases of normal coronary artery.After recording the basic clinical data,all patients underwent routine echocardiography to measure LVEDV,LVESV,SV,LVEF,FS,E / A,Em / Am and other routine indicators.These indicators were compared,and there was no significant difference between the observed indexes.At the same time,the longitudinal strain,radial strain and circumferential strain(LS,RS,CS)of the left ventricle were obtained by software analysis after the two-dimensional speckle tracking imaging technique.To observe whether there was any significant difference between the parameters of each group.We can evaluate sensitivity and specificity of different degrees of coronary artery stenosis by ROC.Then we discuss the value of clinical diagnosis of coronary heart disease with 2D-STI.Results: There was no significant change in LS in patients with normal coronary artery and mild coronary artery stenosis(p> 0.05).But LS started to reduce from moderate stenosis.It was pro gressive decreased with the degree of coronary ar tery stenosis.There was no significant change in RS and CS in patients with normal coronary artery、 mild coronary artery stenosis and moderate coronary artery stenosis(p> 0.05),but decreased from the severe stenosis group(p <0.05).At the same time the rest of the group have no obvious differences(p>0.05).When evaluating meaningful parameters,the cutoff value of LS to diagnose mild stenosis was-17.8,with the sensitivity 57.7% and specificity 59.6 %(area under ROC curve [AUC]=0.59,p<0.05).The cutoff value of LS to diagnose severe stenosis was-16.8,with the sensitivity 84.6% and specificity 83.3%(area under ROC curve [AUC]=0.85,p<0.01).Conclusions: When the left ventricular ejection fraction was not significantly reduced,dysfunction had existed in patients with CHD.The LS、RS and CS of the left ventricular myocardium has begun to decrease.In the diagnosis of coronary heart disease to predict the value of the higher diagnostic value is the longitudinal strain,the greater the degree of stenosis,the more serious damage.With the degree of stenosis increasing,the function is aggravating.2D-STI can evaluate the degree of coronary artery stenosis in the early stage of coronary artery lesion severity.The most important is that it can provide a new noninvasive,accurate and convenient method for assessing the left ventricular function in patients with C HD.