Abstract
BackgroundThe purpose of this study was to evaluate left ventricular systolic function in patients with different types of ischemic heart disease using two-dimensional speckle tracking imaging (2D-STI).MethodsWe retrospectively studied patients who were admitted to Peking University Third Hospital from January 2011 to December 2017 due to chest tightness and chest pain. Two hundred forty-two patients were divided into control group, CMD group and obstructive CAD group. The main coronary artery stenosis was confirmed by coronary angiography or coronary computed tomography and coronary flow reserve (CFR) in patients was measured by transthoracic Doppler echocardiography. Left ventricular strain and strain rate (SR) measured by 2D-STI. Cardiac structure and function were measured by conventional echocardiography.ResultsConventional echocardiography showed that there was no significant difference in cardiac structure and function among the three groups (P > 0.05). Moreover, the longitudinal strain (LS) of each ventricular wall in CMD group was notably lower than that in control group (P < 0.01). In addition, global longitudinal SR and longitudinal SR in CMD group and obstructive CAD group were obviously lower than those in control group (P < 0.01). GLS, endocardial LS and epicardial LS were negatively correlated with CFR (P < 0.01).ConclusionsEarly left ventricular systolic dysfunction was found in patients with CMD and patients with obstructive CAD, with similar degree. CFR is an independent influencing factor of GLS. GLS and stratified LS have certain diagnostic value for CMD.
Highlights
Ischemic heart disease is the leading cause of death in patients with cardiovascular disease [1]
Coronary microvascular dysfunction (CMD) and obstructive coronary heart disease (CAD) can cause myocardial ischemia at the levels of myocardial microcirculation and epicardial coronary artery respectively, which can lead to abnormal cardiac structure and function and participate in the occurrence and development of heart failure [4, 5]
The results showed that GLS of left ventricle in patients with CMD and obstructive CAD decreased significantly, and there was no statistical difference between the two groups
Summary
Ischemic heart disease is the leading cause of death in patients with cardiovascular disease [1]. Coronary microvascular dysfunction (CMD) and obstructive CAD can cause myocardial ischemia at the levels of myocardial microcirculation and epicardial coronary artery respectively, which can lead to abnormal cardiac structure and function and participate in the occurrence and development of heart failure [4, 5]. Obstructive CAD is one of the most common causes of heart failure [4] It causes rational remodeling of heart disease through pathological mechanisms, such as myocardial ischemia, reperfusion injury and excessive activation of neurohormones, and impairs cardiac systolic and diastolic functions [6]. The purpose of this study was to evaluate left ventricular systolic function in patients with different types of ischemic heart disease using two-dimensional speckle tracking imaging (2D-STI)
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