Abstract
Background To explore the application value of layered strain technique in non-ST elevation acute coronary syndrome (NSTE-ACS). Methods 120 patients with suspected NSTE-ACS undergoing coronary angiography in our hospital from December 2018 to December 2019 were prospectively selected. According to the results of coronary angiography, the patients were divided into the significant CAD group and the nonsignificant CAD group. Echocardiography was performed 1-2 hours before invasive coronary angiography. The long axis and circumferential strain of the endocardium, myocardial layer, and epicardium were evaluated by the layered strain technique. The territorial longitudinal strain (TLS), the global longitudinal strain (GLS) of the three myocardial layers, and the global circumferential strain (GCS) were calculated based on the perfusion region of the three coronary arteries and the 17-segment model of the left ventricle. The primary endopoints were TLS and GCS of the three-layer myocardium. Results Compared with the nonsignificant CAD patients, the TLS and GCS of three-layer myocardium in significant CAD patients were decreased, especially in the endocardium. The absolute values of TLS and GCS of the endocardium and epicardium in significant CAD patients were lower than those in nonsignificant CAD patients. This indicates a significant decrease in endocardial function. Receiver operating characteristic (ROC) curve analysis showed that endocardial TLS was superior to LVEF, Troponin I (TnI), and other strain parameters in evaluating the extent of coronary lesions. Conclusions The layered strain technique of 2D-STE can evaluate the severity of coronary lesions in patients with NSTE-ACS, and for significant CAD patients, endocardial function is significantly more impaired than epicardial function.
Highlights
To explore the application value of layered strain technique in non-ST elevation acute coronary syndrome (NSTEACS)
It is more important for clinicians to accurately select patients who really need coronary angiography for revascularization to reduce the complications related with the operation and reduce the medical costs during the treatment process [1]
The long-axis strains of the endocardium, myocardial layer, and epicardium were recorded in the apical views, and the circumferential strains were recorded in the parasternal short-axis views
Summary
To explore the application value of layered strain technique in non-ST elevation acute coronary syndrome (NSTEACS). Compared with the nonsignificant CAD patients, the TLS and GCS of three-layer myocardium in significant CAD patients were decreased, especially in the endocardium. The absolute values of TLS and GCS of the endocardium and epicardium in significant CAD patients were lower than those in nonsignificant CAD patients. This indicates a significant decrease in endocardial function. The layered strain technique of 2D-STE can evaluate the severity of coronary lesions in patients with NSTE-ACS, and for significant CAD patients, endocardial function is significantly more impaired than epicardial function. Strain ultrasound can be more sensitive and accurate in identifying the degree of coronary lesions in patients with NSTE-ACS [3]. The latest layered strain analysis software can evaluate the myocardial morphology of the endocardium, myocardial layer, and epicardium separately, among which the endocardium is the most sensitive to myocardial ischemia, and careful evaluation of the endocardial
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