| Objective:To provide objective,non-invasive and accurate assessment methods for the early diagnosis and intervention of myocardial lesions in NSTE-ACS with patients by quanti tative layer-specific strain technique in evaluation of the global and territorial systolic function of left ventricular three-layer myocardium in patients with non-ST-segment cor onary syndromes(NSTE-ACS).Methods:To select NSTE-ACS patients admitted to the Department of Cardiology in the G eneral Hospital of Ningxia Medical University from January to December of 2016,qua ntitative layer-specific strain technique was used to respectively obtain the global longi tudinal strain(GLS),territorial longitudinal strain(TLS),global circumferential strain(G CS)and territorial circumferential strain(TCS)from Subendocardial myocardium,midd le myocardium and epicardial myocardium.Sixty patients with NSTE-ACS who were diagnosed by coronary angiography(CAG)with stenosis of more than 50% were screen ed.According to multi-vessel disease of CAG,it was divided into single coronary sten osis group(20 cases),double coronary artery stenosis group(20 cases)and three coro nary artery stenosis group(20 cases).And in the same period of suspected NSTE-ACS patients with negative CAG was as a matching control group,than to Count the corre sponding GLS and GCS of the four groups.According to the results of CAG,the left ventricular myocardium was divided into normal segments and infarcted segments.Thenumber of infarcted myocardial segments and the corresponding TLS and TCS were calculated and the results were analyzed.Results:1.Longitudinal strain of left ventricular three-layer myocardium:compared with the control group,GLS of three-layer myocardiumleft of ventricular and TLS of the affecte d segment were decreased in patients with NSTE-ACS coronary artery stenosis(p<0.05),NSTE-ACS coronary stenosis among the groups compared with each other,left vent ricular three layers of GLS and infarcted segments TLS were no significant differen ce.2.Circumferential strain of left ventricular three-layer myocardium:compared with t he control group,GCS of left ventricular three-layer myocardium and TCS of the affe cted segment were decreased in patients with NSTE-ACS coronary artery stenosis(p<0.05).There was no statistically significant difference in the GCS between the three layer s of left ventricular myocardial stenosis among the NSTE-ACS coronary stenosis grou ps.Compared with the NSTE-ACS single coronary stenosis group,only infarcted segm ents TCS of the middle ventricular myocardium were decreased in the two or more c oronary artery stenosis groups.3.As the lesion counts increased,the average GLS level of the subendocardial my ocardium in 4 groups was gradually decreased(p<0.05).4.ROC curve analysis of TCS was diagnostic for single-vessel disease and two or more lesions(p<0.05),When the TCS?17.37 in the middle layer was judged as two or more lesions,the sensitivity of diagnosis at this time was 90.46%,the specificity wa s 63.33%,and the Yoden index was 0.538.Conclusion:The application of quantitative stratified strain technique can non-invasively and a ccurately evaluate longitudinal and circular motion of left ventricular myocardium in patients with NSTE-ACS.It may provide valuable information for early clinical diagnosis and intervention in the treatment of NSTE-ACS.The following conclusions can be dra wn:1.In the absence of segmental wall motion abnormalities in conventional echocardi ography,quantitative stratified strain can be found in patients with reduced myocardial strain.2.Coronary artery stenosis?50%,the longitudinal strain and circumferential strain w ere reduced.3.ROC curve analysis TCS?17.37,NSTE-ACS had diagnostic value for single-vess el disease and two or more lesions. |
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