Quantitative Assessment Of The Left Ventricular Function Using Three-dimensional Wall Motion Tracking In Patients With Chronic Myocardial Ischemia Syndrome Undergoing Percutaneous Intracoronary Arterial Stenting

Objective Quantitatively assessment of the left ventricular regional and global systolic function before and after the treatment of percutaneous intracoronary arterial stenting in patients with chronic myocardial ischemia syndrome using three-dimensional wall motion tracking, to assess the value of three-dimensional wall motion tracking in diagnosis of chronic myocardial ischemia syndrome, ischemia myocardium, and the therapeutic effect of percutaneous intracoronary arterial stenting in chronic myocardial ischemia syndrome.Methods37inpatients with clinical symptoms were enrolled during Oct.2010to Oct.2011who were found dysfunction by three-dimensional wall motion tracking first, and each patient’s coronary angiography showed single coronary stenosis, and the treatment was percutaneous intracoronary arterial stenting. According to the target lesion coronary artery implanted with stent,37inpatients were divided into three groups:left anterior descending coronary artery group (n=14), circumflex coronary artery group (n=12), and right coronary artery group (n=11). Normal group was20volunteers with clinical symptoms who were ruled out coronary heart disease by coronary angiography. Before or6months after percutaneous coronary stent implantation patients with chronic myocardial ischemia syndrome were examined by conventional echocardiography, three-dimensional wall motion tracking and coronary angiography. Analysed the left ventricular segment systolic peak three-dimensional strain and global three-dimensional strain with three-dimensional wall motion tracking, evaluated the effect of percutaneous intracoronary arterial stenting, calculated the coronary angiography Gensini score of each chronic myocardial ischemia syndrome group, analysed correlation between global Gensini score and three-dimensional strain before or6months after percutaneous intracoronary arterial stenting. Normal group was checked by three-dimensional wall motion tracking and coronary angiography.Results①Compared with normal group, left ventricular end-diastole dimension and end-systolic dimension dilated and left ventricular ejection fraction decreased in patients with chronic myocardial ischemia syndrome before stent implantation (P<0.05); compared with before stent implantation, left ventricular end-diastole dimension and end-systolic dimension were shrunk and ejection fraction increased6months after stent implantation (P<0.05).②Compared with normal group, in left anterior descending coronary artery group before stent implantation systolic peak three-dimensional strain were obviously decreased in BA, MA, AA, BAS, MAS, AS, AI, AL (P<0.05), in circumflex coronary artery group before stent implantation systolic peak three-dimensional strain were obviously decreased in BP, MP, BL, ML, AL (P<0.05), in right coronary artery group before stent implantation systolic peak three-dimensional strain were obviously decreased in BS, BI, MI, MS, AS (P<0.05).③Compared with patients with chronic myocardial ischemia syndrome before stent implantation, in left anterior descending coronary artery group six months after stent implantation systolic peak three-dimensional strain were obviously increased in AS, AI, AL, BA, MA, AA, BAS, MAS(P<0.05), in circumflex coronary artery group six months after stent implantation systolic peak three-dimensional strain were obviously increased in AL, BP, MP, BL, ML (P<0.05), in right coronary artery group six months after stent implantation systolic peak three-dimensional strain were obviously increased in MS, AS, BS, BI, MI (P③0.05).④Review of coronary angiography six months after stent implantation, found that in37target lesion coronary arteries, the rate of1left anterior descending coronary stenosis was35%, the rest of stenosis rate was less than20%.⑤In patients with chronic myocardial ischemia syndrome before or six months after stent implantation, the global three-dimensional strain was correlated with the corresponding Gensini score, r,=-0.724, P,<0.01, r2=-0.585, P2<0.01.Conclusion Three-dimensional wall motion tracking can quantitatively assess the left ventricular segmental and global systolic function or dysfunction in patients with chronic myocardial ischemia syndrome with or without percutaneous intracoronary arterial stenting, helping with the diagnosis of chronic myocardial ischemia syndrome, ischemia myocardium and evaluation in the therapeutic effect of stent implantation.