Gene-oriented Clinical Pathway For Individualized Treatment Decision-making In Patients With Coronary Heart Disease Ultrasound Imaging Assessment

Objective: Combining the use of two-dimensional speckle tracking technology and real-time full-volume three-dimensional echocardiography to study the changes in left ventricular structure and function in patients with different genotyping coronary heart disease,which provide a reliable reference for the construction of accurate treatment and clinical assessment of patients with coronary heart disease.Methods: Eighty patients with coronary heart disease who were admitted to our hospital and confirmed by coronary angiography were selected.After PCI in our hospital,individualized treatment or routine treatment was performed according to their genotyping.Among the selected cases,54 patients in the individualized treatment group A group(including 28 patients in the fast metabolic A1 group and 26 patients in the non-rapid metabolic A2 group),and 26 patients in the conventional treatment group B group.Before joining the study,each patient and their relatives should fully understand the risks and complications and sign an informed consent form.The patient's left lateral position was connected to an electrocardiogram,using the Philips EPIQ 7C color Doppler ultrasound diagnostic apparatus,selecting a two-dimensional heart probe S5-1,a three-dimensional full-volume heart probe X5-1,to measure the basic parameters of the patient's heart: LAAPD,IVSEDD,LVPWEDD,LVEDD,LVESD;left ventricular volume and functional parameters: LVEDV,LVESV,3D-LVEF,LVLGS,LVGCS,and MSR of the left ventricular wall;left ventricular synchronization parameters:Tsmv-16-SD and corrected parameter Tsmv-16-SD%.Each patient received an echocardiographic examination after admission and continuous medication for 6 months,and analyzed the above data.Results: Comparison of basic parameters of the patient's heart: After admission and continuous medication for six months,the basic parameters including HR,LAAPD,IVSEDD,LVPWEDD,LVEDD,and LVESD did not change significantly,and there was no statistically significant difference between the two groups(P> 0.05).Comparison of left ventricular volume and functional parameters: There were no significant differences in LVLGS,LVGCS,3D-LVEF,EDV,ESV,and MSR of left ventricular wall between the three groups(P> 0.05).After 6 months of continuous medication in three groups,compared with the admission of this group,LVLGS,LVGCS,3D-LVEF and MSR of each left ventricular wall were significantly increased;EDV and ESV were significantly reduced,the difference was statistically significant(P < 0.05).After 6 months of continuous medication,the data of LVLGS,LVGCS,3D-LVEF and MSR of the left ventricle wall showed that A1 and A2 groups were higher than B group,EDV and ESV were lower in A1 and A2 groups.In group B,the difference was statistically significant(P <0.05);compared group A1 group with group A2,LVLGS,LVGCS,3D-LVEF,EDV,ESV,and MSR of left ventricular wall showed no significant difference(P> 0.05).Comparison of left ventricular synchrony parameters: There was no significant difference in Tsmv-16-SD and Tsmv-16-SD% between the three groups at admission(P> 0.05).Compared with the admission of this group,the Tsmv-16-SD and Tsmv-16-SD% of the three groups were significantly reduced after 6 months of continuous medication,and the difference was statistically significant(P <0.05).After 6months of continuous medication,the results of Tsmv-16-SD and Tsmv-16-SD%showed that the date of both group A1 and A2 were lower than group B,the difference was statistically significant(P <0.05);Compared group A1 with group A2,there was no significant difference between Tsmv-16-SD and the corrected parameter Tsmv-16-SD%(P> 0.05).Conclusion: Compared with conventional treatment,after individualized treatment of patients with coronary heart disease,the left ventricular volume and synchronization are significantly improved.Especially compared with conventional treatment,the left ventricular volume and function improved more significantly in patients under individualized treatment,and the effect was better.Among them,there was no significant difference between the two groups in individualized treatment.Real-time three-dimensional echocardiography and two-dimensional speckle tracking technology play a vital role in the assessment of cardiac function after early coronary heart disease treatment.