Evaluation On Left Ventricular Systolic Function In The Patients With Coronary Artery Disease After Percutaneous Coronary Intervention By Three-dimensional Speckle Tracking Imaging

Objective:To evaluate the left ventricular segmental strains,global strains and systolic function in patients with coronary artery disease(CAD)without regional wall motion abnormalities(RWMA)before and after percutaneous coronary intervention(PCI)by three-dimensional speckle tracking imaging(3D-STI)Methods:Thirty patients with coronary artery disease who underwent coronary angiography and PCI in our hospital from October 2016 to October 2018 were enrolled in this study.The CAD group included 18 males and 12 females,mean age 59.9±8.4 years;Routine echocardiography and 3D-STI were performed 1 day before surgery and 3 months after surgery.All selected patients underwent conventional echocardiography 1 day before surgery without RWMA by traditional echocardiography,and left ventricular ejection fraction(LUEF)>50%.Patients were enrolled confirmed with coronary angiography,(the degree of left anterior descending stenosis?75%,the degree of left circumflex coronary artery stenosis and right coronary artery stenosis were<50%)and PCI were successfully performed Exclusion criteria:patients with acute ST-elevation myocardial infarction;patients with prior myocardial infarction;arrhythmia;patients with coronary artery disease who had been treated with percutaneous coronary intervention(PCI);congenital heart disease;cardiomyopathy;heart valve disease;pericardial disease;chronic obstructive pulmonary disease.30 patients were selected as the control group after exclusion of CAD by medical history,electrocardiogram,echocardiography and coronary angiography.The control group included 20 males and 10 females,mean age 57.6±6.3 years;Routine echocardiography and 3D-STI were performed 1 day before surgery All parameters were collected by GE vivid E9 Color Doppler ultrasound system,equipped with Echo PAC workstation.Conventional echocardiographic parameters were measured,diameter of left atrium;ventricular septal thickness;left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF)measured by using Simpson's biplane method.The left ventricular global longitudinal strain(GLS),radial strain(GRS),circumferential strain(GCS)and area strain(GAS)values and the strain values of the 17 segments of the left ventricle were measured by 3D-STI.We analyze and compare the changes of parameters between the control group and the CAD group 1 day before surgery and 3 months after surgery.Results:1.Compared with the control group,there were no statistically significant differences in the mean age,gender composition and the proportion of hypertension and diabetes in CAD group(p>0.05).2.Compared with the control group,there were no statistically significant differences in the diameter of left atrium,ventricular septal thickness,LVEDV,LVESV and LVEF measured by conventional echocardiography in the CAD group before PCI(p>0.05).Compared with the CAD group before PCI,there were no statistically significant differences in the diameter of left atrium,ventricular septal thickness,LVEDV,LVESV and LVEF measured by conventional echocardiography in the CAD group after PCI(p>0.05).3.Compared with the control group,the absolute values of GLS,GRS,GCS and GAS in the CAD group before PCI were significantly decreased(p<0.05).Compared with the CAD group before PCI,the absolute values of GLS,GRS,GCS,and GAS in the CAD group after PCI were significantly increased(p<0.05),but still lower than the control group(p<0.05).4.Compared with the control group,of the left ventricular segmental strain values,the absolute values of 9/17 longitudinal strain(LS),6/17 radial strain(RS),8/17 circumferential strain(CS),8/17 the area strain(AS)of the CAD group before PCI were significantly lower than those in control group(p<0.05).The segments with decreased strain absolute values were mainly concentrated on the basal segment of the anterior septum,the basal segment of the anterior wall,the middle segment of the anterior septum,the middle segment of the anterior wall,the apical segment of the anterior wall.The absolute values of above strains were significantly improved after PCI compared with that before PCI(p<0.05).However,they were still significantly lower than the control group(p<0.05).Conclusion:3D-STI can analyze left ventricular segmental strains,left ventricular global strains and left ventricular global systolic function in the patients with coronary artery disease quantitatively and non-invasively.3D-STI can detect coronary artery lesions in patients with coronary artery disease with no regional wall motion abnormalities relatively early.The absolute values of left ventricular global strains and ischemic segmental strains in the patients with coronary artery disease after PCI were improved compared with preoperative echocardiography.3D-STI can be used to evaluate the efficacy of PCI in coronary artery disease patients without regional wall motion abnormalities.