Assessment Of Left Ventricular Systolic Function And Twist In Multi-vessel Coronary Artery Disease Patients With Normal Wall Motion By Two-dimensional Speckle Tracking Imaging

Objective We sought to evaluate myocardial systolic function in multi-vesselcoronary artery disease patients with normal wall motion (NWM-MVD) by twodimensional speckle tracking imaging.Methods Forty-five NWM-MVD patients were enrolled into this study and thirty-sixsubjects have low risk of coronary artery disease as control group. According to thepresence or absence of coronary collateral, all the patients were divided intoCCC-MVD group and N-MVD group; according to the position of coronaryatherosclerosis mainly involved, all the patients were divided into LCA-MVD groupand RCA-MVD group. The two-dimensional loop-cine was obtained in apical longaxis views and three levels of short axis views of left ventricle. Left ventricular wallwas divided into18segments by Q-analysis software, longitudinal, radial,circumferential systolic strain and global longitudinal strain（GLS）were analyzed，calculated the average of radial and circumferential systolic strain of18segments asglobal radial and circumferential strain（GRS and GCS）, and the average oflongitudinal, radial and circumferential systolic strain of basic (Bas-GLS, Bas-GCS, Bas-GRS), middle (Mid-GLS, Mid-GCS, Mid-GRS) and apex systolicstrain (Ap-GLS, Ap-GCS, Ap-GRS).Results①Coronary collaterals were visible in85.71%coronary total or almost totalocclusion NWM-MVD patients.②Bradycardia was more common in NWM-MVDgroup than that in control group (16/45vs.5/36, P<0.05). The conventionalechocardiography parameters of left ventricular systolic and diastolic function weresimilar between NWM-MVD and control group.③GLS, GRS, Bas-GLS, Bas-GCS,Bas-GRS, Mid-GLS, Mid-GCS were decreased in NWM-MVD group (P<0.05).④Compared to control group, GLS, Bas-GLS, Bas-GCS, Mid-GLS were decreasedboth in N-MVD group and CCC-MVD group (P<0.05), while Mid-GCS was justdecreased in N-MVD group (P<0.05).⑤Compared with control group,LCA-MVD group had worse GLS, Bas-GLS, Mid-GLS, Bas-GCS and Mid-GCS,while RCA-MVD group had worse Bas-GLS, Bas-GCS, Bas-GRS, and RCA-MVDgroup had better Mid-and Ap-strain than LCA-MVD, especially Ap-GCS, whichwas significantly higher than control group (P<0.05).Conclusions①Myocardial systolic function was impaired in MVD patients,especially basal systolic function, and longitudinal systolic function, though they hadnormal wall motion at rest.②NWM-MVD patients without collaterals had moreserious systolic function impairment than that with collaterals.③Systolic functionwere worse in atherosclerosis lesion mainly involved LCA than mainly involvedRCA. Objective To observe the features of left ventricular twist of the multi-vessel coronaryartery disease patients with normal wall motion by two-dimensional speckle trackingimage.Methods We recruited22NWM-MVD patients proved by coronary angiography andechocardiography, and22subjects have low risk of coronary artery disease. Leftventricular torsion, apical and basal short-axis rotations were performed bytwo-dimensional speckle tracking image and Q-analysis software. Left ventricularejection fraction (LVEF) was calculated with bi-plane Simpson’s method.Results A significant correlation was found between Left ventricular (LV) P-tor,A-tor and LVEF (r=0.527and0.505, respectively, P<0.01), but not basal(P>0.05) rotation. There were no significant change in LV rotation and torsion,though LV basal rotation were decreased in NWM-MVD group, meanwhile apicalrotations and LV torsion were increased (P>0.05). The difference between LV apicalrotation and the absolute value of basal rotation at peak and AVC time in NWM-MVDgroup was significantly increased (P<0.05).Conclusions LV P-tor and A-tor correlated with LVEF. There was no significantchange in LV rotation and torsion in NWM-MVD patients. Increased A-tor mightbe the main compensatory mechanism to maintain normal LVEF in NWM-MVDpatients.