Evaluation Of Left Ventricular Twist Using Three-Dimensional Speckle Tracking Echocardiography In People With Coronary Artery Disease

Coronary artery disease is caused by stenosis of coronary artery. It hasdifferent clinical manifestations and prognosis by severity. Light patients cannot have any symptoms, severe cases can cause sudden cardiac death.Prognosis of patients with coronary heart disease may be due to differenttreatment timing:Timely treatment of ischemic myocardium and reperfusiontimely will cause lesser degree of myocardial damage, myocardial contractilityrecovery soon, along with recovery of systolic function; Conversely, if don’tdiscovery timely and give treatment, longer than myocardial reperfusion timewindow.Lack of timely reperfusion in ischemic myocardium, resulting inmyocardial necrosis, myocardial contractility, cardiac ejection reduce, heartfunction decrease. Therefore, early prevention of coronary heart disease, toimprove the detection rate of patients with coronary artery disease hasimportant clinical significance.Objective: We used to mainly based on two-dimensional plane, use the Msuper-, two-dimensional and Doppler ultrasound techniques to assess wallmotion abnormality But the above methods suffered a loss of two-dimensionalimages echo and Doppler ultrasound dependents angle,so they havesignificantly limit.Three-dimensional speckle tracking is a newly developedultrasound technology, auto tracking and describing heart trajectory,responsingthe twist of hear in the three-dimensional space. The accuracy and feasibilityhas been confirmed by the domestic and international experts. the effectiveejection of heart has closely related to the hart torsional motion. The purposeof this study is application three-dimensional ultrasound speckle tracking toevaluate the twist of left ventricular, to research relationship between twist of left ventricular and left ventricular ejection fraction, and left ventricularthree-dimensional displacement.The Objective of this study is to evaluate left ventricular twist usingthree-dimensional speckle tracking technique in people with coronary arterydisease (CAD) and to research the correlation between twist and left ventricularejection fraction (LVEF) and left ventricular three dimensional displacements.Method: A total of sixty-one patients who undergone coronaryarteriongraphy are classed into two groups, one is normal group withtwenty-nine people(the narrow rate of three coronary arteries is less thantwenty percent),the other is CAD group with thirty-two people(at least onecoronary artery’s narrow rate is more than seventy-five percent).Afteracquisition patient’s three-dimensional full volume dataset, many parameterscan be offered.Peak of left ventricular global twist(PGT) and Time to PGT,Peak of left ventricular basal segment twist(PBT)and Time to PBT, Peak of leftventricular middle segment twist(PMT)and Time to PMT, Peak of leftventricular apical segment twist(PAT)and Time to PAT, Time to aortic valveclose(time to AVC),Peak of left ventricular global three dimensionaldisplacement(P3DD),LVEF, Left ventricular volumes at the end ofdiastole(LVEDV), Left ventricular volumes at the end of systole(LVESV).Results: So，we drow some results:compared with normal group,Thevalues of CAD group’s PAT、P3DD、LVEF reduce(P<0.05).while values ofPBT and PMT a little increase(P>0.05).The values of PGTreduce(P>0.05).The PAT has a good correlation with LVEF andP3DD(r=0.547、r=0.541). The PBT has a weak correlation with LVEF（r=0.034、r=0.114） and P3DD（r=0.108、r=0.053）.Conclusion: We can come a Conclusions that Using Three-DimensionalSpeckle Tracking Echocardiography studies the cardiac three-dimensionalspace motion, avoiding dependency of angle and echo loss, non-invasion, reflecting left ventricular twist motion of CAD patients from mechanics, so ithas extensive application.