The Application Of CMQ Technique In Quantitative Assessment Of Left Ventricular Regional Function In Patients With Coronary Artery Disease

Background:Until now, the echocardiographical assessment of left ventricular regional systolic and diastolic function in patient with coronary artery disease is still confounding. CMQ(cardiac motion quantification) is a new technique which may provide more information about the cardiac movement.Objectives:1). to explore the differences of left ventricular regional systolic and diastolic function in different segments so as to find new parameters reflecting the blood supply status of myocardium,2).to assess immediate change of left ventricular regional systolic and diastolic function before and after PCI therapy in segments deficit with blood supplyMethods:1. Study population25CAD patients (13male.12female, average age is59.84±10.37) were enrolled in our study. All the patients underwent coronary angiography and PCI therapy.2.Methods 2.1EchocardiographyIE-33, Philips echo machine with X5-1transducer was used. Patients were in left recumbent position and ECG was attached. Images of apical four, two-chambers and long-axis view were obtained. Clips were recorded in3consecutive heart beat. CMQ technique was performed1day before the PCI therapy and2days after the therapy.2.2Data processingThe myocardial segments were classified into three groups, normal segments (stenosis <50%), confounding segments (50%<stenosis<70%) and ischemic segments (stenosis>70%) according to the degree of supply vessel stenosis. The segmental systolic peak strain (Ss), the time to peak strain (T) and early diastolic peak velocity (Ve) were measured among the three groups before the PCI. Ss, T and Ve were also compared before and after PCI therapy in abnormal segments (ischemic segments and confounding segments).3Statistical analysisSoftware SPSS (version16.0) was used for statistical analysis. All the results are expressed as mean±tandard deviation (SD). Differences among three groups were tested by one-way ANOVA, and the differences of parameter before and after PCI surgery were done by Paired-t test. All tests were2-sided and P<0.05was considered significant.Results:1.General states:There are419segments with satisfactory image suitable to analyze,175normal segments,59confounding segments and185ischemic segments.2.Compared to normal segments, the absolute value of Ve decreased in confounding and ischemic segments (p<0.05), while there was a tendency for T to prolong in the latter two groups before PCI therapy. Compare to normal segment, Ss tends to increase in confounding segments, so it is also with ischemic group when comparing with confounding segments. But Ss is significantly increased in ischemic group than normal group (p<0.01). Compared to pre-PCI period, there was no significant difference in Ss and Ve after PCI surgery (p=0.917,0.822), but T was significantly shortened after the PCI therapy in ischemic segments (p=0.004).Conclusion:CMQ technique might be a promising tool to identify segments wall motion abnormality with different blood supply status and evaluate PCI therapy for better diagnosis and prognosis.