Evaluation of globle and regional left ventricular myocardial systolic function in patients with coronary stenosis by real-time three-dimensional speckle tracking imaging

Abstract

Objective To explore the value of real-time three-dimensional speckle tracking imaging （RT-3D-STD in the early detection of globle and regional left ventricular myocardial systolic function in patients of coronary stenosis without regional wall motion abnormality. Methods 64 coronary stenosis patients without regional wall motion abnormality were divided into 2 groups according to angiography （CAG） ：without coronary stenosis group（ n = 20） and coronary stenosis group （n = 44） , and all the myocardial segments of the patients were divided into 5 groups., without coronary stenosis group normal myocardial segments （n = 340）, coronary stenosis group normal myocardial segments （n = 235）, mild coronary stenosis myocardial segments（ n = 126）, moderate coronary stenosis myocardial segments（ n = 213） and severe coronary stenosis myocardial segments（ n = 174）.Real-time three-dimensional full volume of left ventricle was obtained, left ventricular global area strain （GAS）and regional area strain（AS） of 17 myocardial segments, etc, were measured by RT-3D-STI respectively. The parameters between the two groups and among the five sub groups were compared, the correlation between GAS and coronary artery Gensini score was also analyzed. Results GAS in coronary stenosis group significantly reduced compared with without coronary stenosis group（ P 〈0.05）.Segmental AS gradually reduced with the increasing of the degree of the coronary stenosis. There was no statistically difference of segmental AS among without coronary artery group normal myocardial segments, coronary stenosis group normal myocardial segments and mild coronary stenosis myocardial segments（ P 〉0.05）.Segmental AS in moderate and severe coronary stenosis myocardial segments significantly reduced （P 〈 0.05 ）, and that in severe coronary stenosis myocardial segments was lower than that in moderate coronary stenosis myocardial segments, the differences were statistically significant （P 〈 0.05）. In addition, GAS was significantly correlated with coronary artery Gensini score（ r = 0.828, P 〈0.01 ）.Conclusions RT-3D-STI can quantitatively assess the early changes of left ventricular globle and regional myocardial systolic function in patients with coronary stenosis. Key words: Echocardiography,real-time three-dimentional; Coronary stenosis; Ventricular function,left ; Regional wall motion abnormality; Speckle tracking imaging