Evaluation Of Left Ventricular Systolic Function And Synchronization In Patients With Left Anterior Descending Coronary Artery Stenosis By Three Dimensional-speckle Tracking Imaging And Real-time Three Dimensional Echocardiography

Objective:To explore the clinical value of application of three-dimensional speckle tracking imaging(3D-STI)and real-time three-dimensional echocardiography(RT-3DE)in the evaluation of left ventricular synchrony between myocardial strain and myocardial contraction in patients with left anterior descending coronary artery stenosis,It provides a convenient and objective new method for accurately assessing myocardial damage in patients with coronary artery stenosis..Methods: 60 cases with coronary heart disease patients as the observation group,they were divided into group A(stenosis rate less than 70%)30 cases,group B(stenosis rate between 70% and 100%)30 cases according to the severity of left anterior descending artery(LAD)stenosis in CAG results,30 healthy volunteers were enrolled as control group.Using the Philips EPIQ 7C color Doppler ultrasound diagnostic apparatus to collect four cardiac cycle images,using RT-3DE software analysis,to obtain the left ventricular global contraction function parameters:left ventricular enddiastolic volume,left ventricular endsystolic volume,left ventricular ejection fraction、stroke volume,The left ventricular time-volume heart rate calibration curve was also obtained and the left ventricular 16 segment the time to minimal systolic volume of 16-segmental’standard deviation and mixmal difference,Tmsv 16-SD,Tmsv 16-Dif was recorded,which did not include the apical segment.After correction with R-R time,Tmsv 16-SD/R-R,Tmsv 16-Dif/R-R were obtained,Then get the synchronization parameters of LAD regional myocardial segments(BA,BAS,MA,MA,AA,AS):Tmsv Sel-SD/R-R,Tmsv Sel-Dif/R-R.Then 3D-STI software was used to analyze the images to obtain left ventricular myocardial strain curve and bull’s eye.All patients were analyzed LAD regional myocardial segments strain parameters including the mean longitudinal strain(MLS),mean radial strain(MRS),mean circumferential strain(MCS).Compared all parameters of three groups,and analyze the correlation between strain parameters and synchronization parameters.Results: There was no significant difference in LVEDV,LVESV,EF,and SV betweensubgroup A with control group and subgroup B.There was a significant difference in LVEDV between subgroup B and control group(P<0.05);MLS,MRS and MCS of subgroup A were smaller than control group,and MLS,MRS and MCS in subgroup B were smaller than subgroup A and control group(P<0.01);Tmsv Sel-SD/R-R,Tmsv Sel-Dif/R-R,Tmsv 16-SD/R-R and Tmsv 16-Dif/R-R of subgroup A were larger than control group,Tmsv Sel-SD/R-R,Tmsv Sel-Dif/R-R,Tmsv 16-SD/R-R and Tmsv 16-Dif/R-R of subgroup B were larger than subgroup A and control group(P<0.01);Tmsv Sel-SD/R-R,Tmsv Sel-Dif/R-R,Tmsv 16-SD/R-R 和 Tmsv 16-Dif/R-R with MLS,MRS,MCS have a certain correlation,The correlation between Tmsv Sel-SD/R-R and MLS is the highest,the value of r is 0.529(P<0.01).Conclusion: 3D-STI was used to evaluate the left ventricular myocardial strain in patients with left anterior descending coronary artery stenosis,and RT-3DE was used to evaluate the left ventricular synchronization,the combination of the two can be used to evaluate the left ventricular function change in patients with coronary artery stenosis.