The Study Of Left Ventricular Myocardial Echo And Systolic Function Before And After Percutaneous Transluminal Coronary Angioplasty In Coronary Heart Disease

Objective: To evaluate the ventricular myocardial echo and systolic function before and after PTCA by ultrasonic integrated backscatter,tissue doppler imaging,acoustic quatification and color kinesis technique and investigate the action and relation between the four techniques.Method:The anterior wall , inferior wall , posterior wall, and lateral wall were detected at parasternal papillar muscle short axis view by adquisition densitometry of IBS ,TDI, AQ, CK in 33 cases of patients (male 26 cases, female 7 cases, average age 63.5±6 years) with coronary heart disease,operated by PTCA+stent at selected time and analyse changes of left ventricular echo and systolic function of 1-3 days before PTCA, 3 days and 1-3 months after PTCA.The contents mainly studied: (1)Wall motion was measured by 2DE;(2)By AD-IBS, to measure:①myocardial average integrated backscatter value, that is, myocardial average image intensity (AII); ② standardized myocardial integrated backscatter, that is, myocardial average integrated backscatter value contrary to that of intraluminal blood near to the segment myocardium;③cyclic variable integrated backscatter, CVIB;④CVIB ofendocardium, subepicardium, and transmural gradient index(TGI): CVIB of 1/2 inner and outer myocardium layer, that are, CVIBen,CVIBep, TGI=(CVIBen-CVIBep)/CVIBen;(3)Peak systolic velocity of subendocardial,subepicardial and middle layer myocardium of the segments (Ven) ,(Vep) ,(Vm), transmural velocity gradient ( Ven-Vep),and systolic peak velocity of outer lateral mitral valve annulus were measured by pulse wave model of TDI ;(4)left ventricular ejection fraction(EF) and end diastolic volume(EDV) were measured by AQ;(5)Wall motion extents of the segments were measured by CK.Result: To the viable myocardium of left ventricle, parameters of integrated backscatter have improved at the 3th day after operation ,and have statistical significant ; systolic velocity of local myocardium and mitral valve measured by PW-TDI, EF,EDV measured by AQ, wall motion extent measured by CK have a little increase at the 3th day after operation, but have not apparent statistical significant, left ventricular viable myocardium echo and systolic function all have Improved at the follow-up study. Conclusion: PTCA can effectly save viable myocardium. Ultrasonic new techniques evaluate PTCA together,which can provide more indexs and more messages.