Evaluation Of Left Ventricular Myocardial Strain By Three-plane Speckle Tracking Imaging And The Relationship With Lesion Severity In Patients With Coronary Artery Disease

Objective: Using Three-plane Speckle Tracking Imaging(3P-STI)to evaluate left ventricular systolic function in patients with coronary artery stenosis.To explore the clinical value of 3P-STI as a non-invasive method in detecting the severity of coronary artery stenosis in patients with coronary artery disease(CAD).Methods: The study included patients with suspected CAD,but wall motion without obvious abnormalities by conventional echocardiographic,and with coronary angiography(CAG)examination.Totally 103 patients according to the CAG results and Gensini score,the patients was divided into control group(Gensini score =0,n=24)and lesion group(n=79).Patients in lesion group were divided into mild subgroup(Gensini score <25,n=40),moderate subgroup(Gensini score 25~50,n=26),and severe subgroup(Gensini score >50,n=13).All patients enrolled in the left lateral position were connected with electrocardiogram.The following conventional echocardiographic parameters were measured: left ventricle(LV)inflow peak spectral velocity(PSV)of the E-wave and A-wave,LV end-diastolic volume(EDV),LV end-systolic volume(ESV),and LV ejection fraction(LVEF).The average global longitudinal strain(GLS-Avg),basal segment global longitudinal strain(GLS-Bas),middle segment global longitudinal strain(GLS-Mid)and apex segment global longitudinal strain(GLS-Ap)were measured by 3P-STI.Comparison of general clinical data,conventional echocardiographic parameters,and 3P-STI parameters between the two groups.Differences in 3P-STI parameters between three subgroups,and Pearson correlation analysis was used to analyze the correlation between GLS-Avg,GLS-Bas,GLS-Mid,GLS-Ap and Gensini score.The ROC curve was drawn,and the 3P-STI parameters were evaluated for the diagnostic efficacy of the normal and mild coronary lesion group(coronary Gensiniscore < 25)and the moderate and severe disease group(coronary Gensini score ?25).Results:There were no significant differences in the general data of age,gender,body mass index(BMI),diabetes,hypertension,and hyperlipidemia between the lesion group and the control group(p>0.05).All patients enrolled in patients with normal wall motion,early changes in early changes in myocardial damage.Conventional echocardiography has low sensitivity for detecting early myocardial damage,so there was no significant difference in the parameters of conventional echocardiography between lesion group and the control group(p>0.05).The left ventricular longitudinal strain in patients with CAD was lower than control group.The GLS-Avg,GLS-Bas,GLS-Mid and GLS-Ap in lesion group were lower than the control group,and the differences were statistically significant(p<0.05).Different subgroups with different Gensini scores.There were significant differences in GLS-Avg,GLS-Bas,GLS-Mid and GLS-Ap in lesion group(p<0.05).Correlation analysis between Gensini score and GLS-Avg,GLS-Bas,GLS-Mid and GLS-Ap(r=0.655?0.529?0.617?0.617)were done.GLS-Avg,GLS-Bas,GLS-Mid,GLS-Ap were positively correlated with Gensini score.ROC curve results showed that the areas under the curve decreased from GLS-Avg(0.902),GLS-Bas(0.854),GLS-Mid(0.847),GLS-Ap(0.826).Conclusion:The left ventricular longitudinal strain obtained by 3P-STI can reflect the changes of left ventricular myocardial systolic function in patients with CAD.By analyzing the degree of motor function damage of the left ventricular myocardium,the severity of criminal blood vessels can be inferred indirectly.With the increase of the severity of coronary artery stenosis,the absolute value of myocardial strain decreases more obviously,and the detection rate is higher.Therefore,3P-STI has a certain value for evaluating the severity of coronary artery disease.