| Objective:Percutaneous transluminal coronary angioplasty(PTCA) and stent implantation is a usual and effective therapy method for coronary artery disease(CAD).In this study, our purpose is to evaluate the changes of ieft ventricular(LV) regional and global function before and after PTCA and stent implantation in patients with CAD by strain rate imaging(SRI) and Tei index.Methods:32 patients who had at least one main brach of coronary artery stenosis(≥75%) confirmed by coronary angiography and 40 normal control subjects were included in the study.32 patients at 1～3d before stent implantation(pre-operation group) and 3±0.2 months after stentt implantation(post-operation group) were examined by echocardiography.The left ventricular eject fraction(LVEF) and transmittal inflow E/A ratio were measured by the conventional echocardiography.Tel index which was in six different sites of mitral annulus was obtained by Doppler Tissue Imaging(DTI) and mean Tei index was calculated.The peaks of strain rate curve at systole(SRs),early diastole(SRe) and late diastole(SRa) at the base and mid segments were measured in three groups.The mean SRs,SRe,SRa of all segments were also calculated.All statistical analyses were performed by SPSS 14.0 for Windows.The measurement data was expressed as mean±standard deviation,inter-group comparison was tested by independent-samples t-test.Pre- and post-operation group comparison was tested by paired-samples t-test.Linear correlation was applied for relation analysis. (P＜0.05:significant;P＜0.01:very significant)Results:1.Compared with normal subjects,the value of LVEF,E/A were lower and Tei index was longer in pre-operation group.SRs of 10 LV segments,SRs of 7 LV segments and SRa of 6 LV segments were also lower.The value of mSRs,mSRe,and mSRa were 0.87s-1,0.81 s-1,0.69 s-1 respectively and they were all lower than normal group.2.The accuracy(AC),sensitivity(Se) and specificity(Sp) of SRs for distinguishing LV regional systolic function reduction in CAD patients were 62.8%,60.2%,60.9% when SRs was 0.9 s-1.The Ac,Se,Sp of SRe for distinguishing LV myocardial relaxation reduction in CAD patients were 69.3%,70.3%,66.1%when SRe was 1.00 s-1.3.There were no differences in LVEF,E/A between pre- and post-operation groups. Tei index was shorter in post-operation group.SRe of 8 LV segments and SRs of 3 LV segments were higher in post-operation group than those of pre-operation group,but SRa was no difference.4.The Ac,Se,Sp of SRs for distinguishing LV regional systolic function recovery in post-operation group were 65.6%,63.5%,67.2%when SRs was 0.78s-1.The Ac,Se, Sp of SRe for distinguishing LV myocardial relaxation recovery in post-operation group were 65.6%,65.6%,65.4%when SRe was 0.90s-1.5.Tei index was negative correlated with LVEF,BSRs(mean SRs of the base segments),BSRe(mean SRe of the base segments),the coefficient was -0.731,-0.397, -0.35 respectively(P＜0.001).LVEF was positive correlated with BSRs and its coefficient was 0.498(P＜0.001).Conclusions:1.LV global function,regional systolic and diastolic function reduced in different degrees,and diastolic function reduced earlier and more obviously in the CAD patients.2.The cutoff value of SRs,SRe that was 0.9s-1,1.00s-1 could distinguish LV regional systolic function and myocardial relaxation reduced respectively.3.LV regional diastolic and systolic function increased in different degrees and diastolic function increased more obviously at 3 months after stent implantation.Tei index could accurately and sensitively evaluate the recovery of left ventricular global function.4.SRs and SRe could distinguish LV regional systolic function and myocardial relaxation recovery respectively after stent implantation.It was firstly found in this study that the cutoff value of SRs and SRe were 0.78s-1,0.90s-1 respectively,their accuracy,sensitivity and specificity were 65.6%,63.5%,67.2%and 65.6%,65.6%, 65.4%.
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