| Objective: The use of speckle tracking technique before and after myocardial revascularization in patients with normal left ventricular ejection fraction(LVEF),the improvement of myocardial rotation and cardiac function has important clinical significance in evaluating the curative effect and prognosis of patients with coronary heart disease.Long-term postoperative myocardial blood supply again.Assessment of changes in myocardial motility and extent of improvement in systolic and diastolic function There are no accurate indicators of ultrasound detection.Objective and quantitative analysis of coronary artery bypass grafting,Effect of myocardial motion changes on left ventricular systolic and diastolic function,Can help us early,sensitive and comprehensive evaluation of long-term efficacy and prognosis of patients after coronary artery bypass surgery.In this study,the use of speckle tracking imaging(STI)and real-time two-dimensional echocardiography(RT-2DE)in patients with coronary artery disease before and after off-pump coronary artery bypass grafting(OPCAB)at different stages,at each time point changes in left ventricular myocardial motion and left ventricular regional and global cardiac function.Methods: Eighty patients with coronary heart disease treated by OPCAB at the First Hospital of China Medical University in 2015.11-2017.3,conventional echocardiography and RT-2DE were performed before surgery,at 1 month and 12 months after surgery respectively,collect conventional ultrasound images and RT-2DE images at the corresponding time points,29 healthy individuals with different age and sex were selected as normal control group,the STI technique was used to offline analyze the two-dimensional ultrasound images of the two groups of subjects and establish the corresponding database,comparative analysis of its conventional echocardiographic parameters,two-dimensional strain parameters of the law,and within each group at each time point correlation.Apply Echopac software to analyze real-time 2D speckle tracking images for VTC,quantitative detection of SDI and two-dimensional global cardiac function parameters,analysis of the change in the difference between the detected values before and after comparison of OPCAB surgery,and compared with the normal control group to analyze the difference,and within each group at each time point correlation.Results: Evaluation of left ventricular systolic function before and after OPCAB in patients with coronary heart disease by 2D speckle tracking imaging;The LVEF values in OPCAB group were significantly lower than those in normal control group(P<0.05),but the OPCAB group within the preoperative,postoperative January and postoperative December LVEF values did not change significantly.In OPCAB group,the indexes of STI left ventricular systolic function decreased at 1month after operation,but STI left ventricular diastolic function index in January after surgery began to improve compared with preoperative.The STI systolic function parameters in the OPCAB group at 12 months after operation were significantly higher than those in the first month after operation,and can reach the preoperative level.The OPCAB group left atrial volume index,Timing hiatus values were significantly correlated with the E / A ratio.Conclusion: STI can quantitatively evaluate left ventricular myocardial motion and changes in local and global cardiac function in patients with coronary artery disease before and after OPCAB surgery.1.Coronary heart disease patients after OPCAB surgery,due to surgical trauma,pericardial incision and other reasons,left ventricular myocardial segments making short-term postoperative local movement to reverse significantly lower than before surgery,but the LVEF value was not significantly reduced at this time.Therefore,when the postoperative left ventricular local twist has changed,but only the LVEF value can not be evaluated.2.Coronary heart disease patients underwent OPCAB for 12 months,regional and global left ventricular twisting motion indicators improved significantly after surgery compared with January,and has reached or exceeded the preoperative level,this shows that after myocardial revascularization,myocardial torsion movement was significantly improved,asynchrony of myocardial motion is corrected,and it is on the rise over time.3.LVEF value does not reflect the changes of cardiac function in patients before and after surgery OPCAB,nor can it be used as an indicator of postoperative outcome and long-term prognosis in patients.Because of left ventricular torsion index of myocardial ischemia sensitive,can reflect the situation of myocardial blood flow through the local myocardial exercise,which in turn reflects the local and global left ventricular function changes,therefore,it can be used to evaluate the improvement of local and global cardiac function in OPCAB patients.4.OPCAB patients with coronary heart line early postoperative left ventricular diastolic function improvement has occurred,prompted by STI technology as measured left ventricular diastolic reverse indicators can be restored in case of an early,sensitive heart function in patients with OPCAB postoperative evaluation,early assessment of coronary artery bypass graft early effect.STI technique can quantitatively evaluate the changes of left ventricular systolic and diastolic function and left ventricular motility before and after OPCAB in patients with coronary heart disease,it has important clinical value in evaluating its therapeutic effect and prognosis.1.Coronary heart disease preoperative left ventricular systolic and diastolic function was significantly reduced,left ventricular systolic motion is not synchronized,OPCAB postoperative left ventricular systolic and diastolic function and left ventricular systolic synchronicity have significantly improved.2.STI technique was used to assess left ventricular systolic and rotational movement to assess long-term local myocardial blood supply after OPCAB,noninvasive detection of left ventricular torsion index to assessment of myocardial blood supply,and simple and convenient understanding of coronary artery bypass graft myocardial blood flow.3.The improvement of global left ventricular diastolic function after OPCAB was earlier than the improvement of global systolic function,therefore,after OPCAB surgery by STI technology monitoring of new indicators of left ventricular diastolic,can be more sensitive,early detection of left ventricular cardiac function changes. |
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