Evaluation Of Left Ventricular Twist And Displacement In Patients With Coronary Artery Disease By Three-dimensional Speckle Tracking Imaging

Objective:To analyze the left ventricular twist and displacement usingthree-dimensional speckle tracking imaging(3D-STI) in patients with Coronary ArteryDisease (CAD) in order to determine the value of3D-STI in quantitative evaluation ofleft ventricular systolic function in patients with CAD.Methods:120patients diagnosed by coronary artery angiography were selected asCAD group including75male patients and45female patients,the range of age wasbetween36and81,the average age was (57.36土12.96) years old, they were dividedinto4groups according to the distribution of the affected coronary arteries:a leftanterior descending coronary artery group (LAD group, n=47), a left circumflexcoronary artery group (LCX group, n=25), a right coronary artery group (RCA group,n=23), a multivessel group (n=25).The disease of the left main lesion was included inthe multivessel group.Forty healthy volunteers were included as a normal control group,25male patients and15female one were included.The range of age was22-76yearsold and the average age was (49.14土12.57) years old.Heart disease was excluded byhistory、physical examination、electrocardiogram and echocardiographic.We used color Doppler ultrasonic system of TOSHIBA ARTIDA,after recordingthe echocardiography images simultaneously,conventional ultrasound parameters wereacquaired by two-dimensional transthoracic probe PST-30SBT,then switch toPST-25SX, the apical full-volume image was obtained to visualize the entire LV in all subjects.All the above images were stored for off-line analysis with3DT analysissoftware.All parameters were obstained,including the peak of left ventricular basalsegment twist(PBT)、middle segment twist(PMT)、apical segment twist(PAT) globaltwist(PGT) and Time to PBT、PMT、PAT、PGT,the global3D displacement(P3DD) andLVEF.Then we compared the above parameters of the two groups.And thecorrelationship between LV twist、LVEF and the displacement in CAD group wasstudied.Results:1.The age、height、weight、heart rate、systolic pressure、diastolic pressurebetween CAD group and the normal control group showed no significantlydifferent(P>0.05).2. The LVEF of the CAD group was lower than the normal controlgroup which had significant difference(P<0.05).The LVIDd、LVIDs、LA、LVESV、LVEDV of the LAD group and the multivessel group were significantlyincreased(P<0.05).3. Compared with the normal control group:(1) The PAT、PGT weresignificantly decreased in the CAD group(P<0.05or0.01);(2)The PBT、PMT of LCXgroup、RCA group were decreased and the time of PBT was delayed (P>0.05);(3)ThePBT and the time to PBT of LAD group were decreased (P<0.05) and the PMT a littledecrease(P>0.05);（4）The PMT、PBT were decreased in multivessel group while thepeak time of rotation of all the segments decreased(P<0.05);4. The globle threedimensional displacement of left ventricular was significantly decreased (P<0.05).TheP3DD of the corresponding segments of LAD group、LCX group and RCA group、allsegments of multivessel group were significantly decreased(P<0.05or0.01);5.ThePGT、PAT、PBT of CAD group and LVEF、P3DD were positively correlated.The PAThas good correlation with P3DD and LVEF(r1=0.53,P1<0.05;r2=0.44,P2<0.05).The PGThad weak correlation with P3DD and LVEF（r1=0.017，P1<0.05；r2=0.009，P2<0.05）.Conclusions: Left ventricular twist and displacement can be studied in real-timethree-dimensional space using3D-STI.And the new technology can sensitivelydiscover the reduce of left ventricular systolic function in patients with CAD,providing important clues for the diagnosis of CAD,and has broad application prospects.