| Objective: To explore relationship between the left ventricular diastolicfunction(LVDF) and lesions stenosis of anterior descending artery proximalunder the guidance of intravascular ultrasound(IVUS) in the patients withcoronary artery disease.Method: Inclusion criteria: patients, who have stable or unstable anginapectoris, and the anterior descending is shown as single lesionExclusion criteria:Acute and chronic myocardial infarction, heart failure,arrhythmia, renal insufficiency, cardiomyopathy, heart valve disease,congenital heart disease, anemia, thyroid disease, the tumor, autoimmunediseases, acute cerebrovascular disease, acute infection.1 Selective coronary angiography was operated by professional physician,via radial artery or femoral artery as approaches. The degree of singlestenosis≥50% in the anterior descending artery proximal was considered aspositive lesions. IVUS examination of the patients were carried out afterangiography.2 IVUS imaging was performed after angiography in all patients. Acommercially available mechanical rotating 30-MHz IVUS catheter and adigital processing IVUS console(Boston Scientific corporation) were used inthis study. IVUS pull-back imaging was performed using an automatedpullback device at a speed of 0.5 mm/s. IVUS images were digitally recordedfor later off-line analysis. The narrowest(by angiography) lesions in theanterior descending artery proximal were measured with the fill narrow cavitydiameter(Max MLD), minimal lumen diameter(MLD), lumen area(LCSA),load of membrane area(EEM CSA) and patches(EEM CSA-LCSA of plaquearea, plaque load = membrane in plaque area/area in mid-membrane by100%).3 Color Doppler echocardiography was taken with sternum beside left forshaft cross section measurement of left atrial diameter(LAD), left ventricularend-diastolic diameter(LVEDD), left ventricular end systolic diameter(LVESD), under this section at the same time, using the ultrasonic instrumentmodified Simpson’s method to calculate LVEDV, LVESV, left ventricularejection fraction(LVEF); Record diastolic peak by mitral valve blood flowdoppler E(E), A peak flow velocity(A), E fengfeng value speed with A speedratio of fengfeng value(E/A). The above indicators measuring three cardiaccycle, and its average, all ultrasonic data storage. To avoid error, each patientfrom staff in accordance with the unified method.All patients, who have stable or unstable angina pectoris and areinstructed to take the coronary angiography test, shall take the general cardiacultrasound test, those who are found have one-vessel lesion, and as anteriordescending artery proximal lesion will be included in the research. Thepatients will be divided into two groups of A and B according to the lesionproximal left anterior descending artery stenosis of the most serious partwhich measured during the surgery, that group A with minimal lumen area is≥4.0mm2, and group B with minimal lumen area is <4.0mm2, and to find outwhether there is any statistic difference between the two groups whencomparing the Cardiac uhrasonography result. Meanwhile to divide thepatients into group c( Plaque burden≥70%) and group d( Plaque burden <70%) in accordance with the plaque burden data measured by IVUS, compare tofind out whether there is any statistic difference of Cardia uhrasonographyresult between the two groups.Result:1 There are statistic differences of LAD, LVDEE, LVDSD between groupA and B(P<0.05), the LAD(3.42±0.32cm), LVEDD(4.75±0.34cm), LVESD(3.01±0.46cm)of team A is lower than team B-LAD(3.62±0.39cm)、LVEDD(5.00±0.51cm), LVESD(3.30±0.56cm), there are statistic differencesof LAD, LVDE, LVDSD between group C and D(P<0.05), which is show thatby IVUS, there is statistic difference of LAD, LVEDD, LVESD resultbetween the two groups.2 There are statistic differences of LAD, LVEDD, LVESD between groupC and D(P<0.05),the LAD(3.61±0.34cm)、LVEDD(5.02±0.55cm), LVESD(3.33±0.65cm)of team C is lower than team D-LAD(3.45±0.35), LVEDD(4.79±0.34cm)、LVESD(3.05±0.34cm), which is show that by IVUS, thereis statistic difference of LAD, LVEDD, LVESD result between the twogroups.3 compare group A and B with C and D that there are no obviousdifference on Left ventricular ejection fraction(LVEF), peak E, peak A andE/A(P>0.05).while, this is because that in the early stages of coronary heartdisease in patients with cardiac insufficiency, peak E reduce, peak A rise, E/Areduce;as heart failure, peak E rise, E/A converts to normal;when the heartfailure is more serious, peak E rise, peak A reduce, E/A rise 。 Groups ofcoronary heart disease patients in this study is in a different period of cardiacinsufficiency, so there is no remarkable statistic difference between E, A, E/A.Conclusion: There is a good relationship between the parameters ofintravascular ultra- sound(IVUS) and left ventricular diastolic function in theproximal left anterior descending artery disease. |
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