Diagnostic Value Of Left Ventricular Myocardial Automatic Functional Imaging Strain Parameters For Coronary Artery Disease With Different Stenosis Degrees

Objective: To investigate the diagnostic efficacy of left ventricular myocardial automatic functional imaging strain parameters on the degree of coronary stenosis,and to provide evidences for the early diagnosis and clinical treatment of coronary heart disease.Methods: A total of 152 patients with suspected coronary heart disease and planned coronary angiography were selected from January,2019 to June,2019 in the Heping Branch of the North Theater General Hospital.Patients' gender,age,heart rate,ejection fraction,smoking history,hypertension,and diabetes were collected.5 groups were divided based on coronary angiography results: Group 0(no stenosis),Group 1(stenosis <50%),Group 2(stenosis 50%-69%),Group 3(stenosis 70%-89%),and Group 4(stenosis 90%-100%).Automatic functional imaging of left ventricular myocardium was performed within 24 hours before angiography,and a 17-segment bull's eye diagram was obtained to measure the global peak longitudinal strain(GLPS)of the left ventricle and the local peak coronary longitudinal strain(LLPS).The differences of GLPS and LLPS in different coronary stenosis were compared.The predictive ability of GLPS and LLPS for coronary stenosis ?50% was evaluated,and the correlation between GLPS and left ventricular ejection fraction was analyzed.Results: 1.The higher the degree of coronary stenosis,the lower the LVEF.There were significant differences between LVEF in the group 4 of anterior descending branch and group 0,1,and 2(P <0.05);LVEF in group 4 of the circumflex branch was significantly different from group 0.(P <0.05);There were significant differences in LVEF between the group 4 of right coronary arteries and 0 and 1 groups(P <0.05).2.With the increase of the degree of branch coronary stenosis,GLPS and LLPS showed a downward trend.Among them,GLPS and LLPS in group 0 and group 1 of the anterior descending branch were significantly different from those of group 2,3,and 4(P <0.05);There were differences in GLPS and LLPS in group 2,3 and 4 of the circumflex branch compared with groups 0 and 1(P <0.05);There were differences in GLPS in group 4 of right coronary artery with group 0 and 1(P <0.05),There were also differences in GLPS between group 2,3 and group 0(P <0.05).3.The area under the ROC curve of GLPS and LLPS of anterior descending branch,circumflex branch,and right coronary artery are 0.872,0.701,0.733,and 0.593,and the cutoff values are-21.50,-19.93,-17.90,and-18.90,of which the area under the GLPS curve is the largest,With the highest sensitivity and specificity,84.40% and 76.50% respectively.4.There was a negative correlation between left ventricular ejection fraction and GLPS(P <0.01),and the correlation coefficient was-0.53.Conclusion:The left ventricular myocardial automatic functional imaging strain parameters have a downward trend with the increase of coronary stenosis.GLPS and LLPS of circumflex branch,right coronary artery,and anterior descending branch,have certain predictive ability for coronary stenosis ?50%,which is helpful for the early diagnosis and treatment of coronary heart disease.