The Value Of Color Kinesis And The Ventricular Wall Thickening Ratio In Coronary Artery Disease Diagnosis

Objective: To explore the diagnostic value of color kinesis(CK)and the ventricular wall thickening ratio(WTR)in patients with coronary artery disease(CAD)Materials and Methods: 45 patients with coronary artery disease(CAD,twenty-six males and nineteen females,aged 55.29±7.01years)comfirmed by coronary artery angiography(CAG)and 30 normal control subjects(fourteen males and fifteen females,aged 53.27±8.59years)were enrolled.HP SONOS 5500 ultrasonic imaging system(2-4MHz transducer)was used. Two-dimensional echocardiograms(2DE)and end-systolic CK images were recorded at standard parastemal LV long view and short view, apical four chamber view(A4C)and two chamber(A2C)view respectively 2DE and CK images. The ejection fraction(EF), wall thickness ratio(the ventricular septum thickness(VST) and LV posterior wall thickness(LVPWT)at end-diastolic phase),wall thickening ratio and rate of E/A were compared between CAD and normal control subjects. The width of color band was measured and changes of each color layer were observed by CK. The relationship between wall and Gensini's scores detected by coronary artery angiography were also analysed.Results:1) There were no significant difference among the mean motion amplitudes of different sections in the same segment measured by CK(P＞0.05).Reproducibility of measurement of each segments was stable in each subjects. There were no significant difference about average between 2DE and CK(P＞0.05), the ejection fraction(EF),wall thickness ratio between patients with CAD and normal control subjects were also no significant difference(P＜0.05). The DT were a little prolonged.2) Abnormal segments in patients with CAD could easily be detected from normal ones, systolic endocardial motion(SEM)amplitude were decreased and displacement time were shortened. Compared with normal control subjects, there were significant difference of SEM and TSEM(p＜0.001).3) The sensitivity of CK,WTR,CK-WTR in the diagnosis of CAD were 88.9％,80.0％and 95.6％,while the specificity were 90.0％,86.6％and 96.7％with accurate rate 89.3％,82.7％and 96.0％respectively.The wall motion scores were closely related to Gensini's(So),CK images(Sc)and WTR(Sa)(So and Sc: r=0.871, So and Sa: r=0.862, Sc and Sa:r=0.849, p＜0.001).4) Reproducibility of measurement: One object measured by two operators has no significant difference(P＞0.05)and the variability is 8.71％. At the same time, one operator measured twice has no significant difference too: the variability is 5.05％ Conclusion:1) There are high sensitive, specific and accurate for diagnosing coronary heart disease combined of Ck and WTR. The reproducibility are stable by different measurements. The CK-WTR is closely related to the results of CAG.2) There are good relationships between coronary artery of blood-supply and region wall motion abnormality detected by CK-WTR.