Evaluation Of Left Ventricular Function After Acute Myocardial Infarction Of PCI With Four-dimensional Echocardiography

Background:The term coronary heart disease(CHD)describes a number of cardiac conditions that result from the presence of atherosclerotic lesions in the coronary arteries.The development of atherosclerotic plaque within the coronary arteries can result in obstruction to blood flow,producing ischemia,which can be acute or chronic in nature.Atherosclerosis is a diserse process that starts at a young age and can be present for years in an asymptomatic form until the degree of vessel obstruction leads to ischemic symptoms of exercise-or stress-related angina;or,in the case of plaque rupture and acute thrombosis,sudden death,unstable angina,or myocardial infarction(MI)may ensure.In the United States,more than 17 million people experience some form of CHD.Approximately 10 million suffer from symptoms of angina,and at least 380,000 deaths occur each year from acute MI or CHD-related sudden death.In our country,acute myocardial infarction(AMI)has become a serious threat to life and health of one of the diseases.Acute myocardial infarction blood flow reconstruction of the main ways there are three,namely: drug thrombolytic therapy,interventional PCI and Coronary artery bypass grafting.PCI as an effective means of reperfusion therapy,can directly open the infarct-related artery,restore ischemic myocardial blood supply,can effectively limit and reduce the infarct size,protect the left ventricular function,improve the patient's ventricular remodeling and short-term prognosis.The predictive value of UCG in acute myocardial infarction is 95% ~ 98%,and it is also an important basis for judging the change of cardiac function after PCI.It is widely used in the evaluation of left ventricular function after PCI in patients with AMI.Objective:In this study,two-dimensional and four-dimensional ultrasonography were performed on patients with 14 days after surgery,2 months after surgery.To evaluate the value of four-dimensional echocardiography in assessing left ventricular cardiac function in patients with acute myocardial infarction(AMI).Methods:Fifty patients with acute myocardial infarction admitted to hospital from April to October in 2016 were enrolled in the study group.Eliminate previous history of myocardial infarction,cardiac insufficiency,malignant arrhythmia,diabetes,renal failure and obesity.2D-LVESV,2D-LVEF,4D-LVEDV,4D-LVESV,4D-LVEF,GLS,GCS,GAS,GRS were recorded in two-dimensional and four-dimensional echocardiography.,The same group of patients after 14 days,2 months were two-dimensional,four-dimensional echocardiography,record the experimental data,respectively,after 14 days,2 months group;emergency PCI 14 days after surgery group,2-month group parameters and preoperative parameters were analyzed statistically,4D-LVEF and ventricular strain parameters were analyzed.Results:There was no significant difference in 2D-LVEDV and 2D-LVEF between postoperative two month and postoperative 7 days(p> 0.05),and 2D-LVESV was significant difference(P <0.05).There was no significant difference in 2D-LVEDV between postoperative two month(p> 0.05),and there was significant difference between 2D-LVESV and 2D-LVEF(p <0.05).There was no significant difference in 4D-LVEDV between postoperative 7 days and preperation(p> 0.05),and the difference between the 4D-LVESV and the 4D-LVEF was statistically significant(p<0.05).Compared with preoperation two month and postoperative 7 days,the difference of 4D-LVEDV and 4D-LVESV was statistically significant(p<0.05).,and 4D-LVEF had no significant difference(P> 0.05).4D-LVEDV,4D-LVESV and 4D-LVEF were statistically significant(p <0.05).Compared with the postoperative group,the GLS,GCS,GRS and GAS were increased,and there was significant difference in GAS between postoperative two month and preoperative(P <0.05).Conclusion:1.Patients with acute myocardial infarction in the emergency PCI after surgery,left ventricular function was significantly improved compared with preoperative.2.Four-dimensional echocardiography in the evaluation of acute myocardial infarction in emergency PCI after left ventricular function evaluation has important value,and earlier than the two-dimensional echocardiography,sensitive and accurate detection of postoperative left ventricular morphology and function Variety.3.The left ventricular ejection fraction and myocardial strain can quantitatively evaluate the left ventricular function before and after PCI in patients with acute myocardial infarction.The myocardial strain parameters can be used to evaluate the myocardial motion of the ventricular wall more comprehensively,accurately and sensitively(GAS)in the four-dimensional strain is the most sensitive in determining left ventricular myocardium movement.