The Analysis On Clinical Manifestations Of Patients With Normal Wall Motion In Triple Vessel Coronary Artery Disease

As the occurrence of coronary atherosclerotic heart disease, atherosclerosis within theartery leads to stenosis and regional myocardial blood flow reduction. The process ofischemia can result in impaired systolic and diastolic function of the myocardial cells, andthe gradual emergence of movement abnormal state, thus showing regional wall motionabnormality. This pathophysiological process in the coronary tri-vessel disease should bemore obvious, and then ventricular wall motion abnormalities perform. However, in somepatients, ventricular wall motion shows a normal movement. To associate with coronaryheart disease risk factors and pathophysiological changes, consider the reason to thecoronary tri-vascular disease with normal ventricular wall motion may: the limitations of thecolor Doppler Echocardiography, ischemic preconditioning and the formation of cardiaccollateral circulation. coronary tri-vessel disease proves a kind of more widely dispersed, andmore serious disease, but binding with normal performance of the ventricular wallmovement in echocardiography, it seems more likely to result in diagnostic omissions, andeventually lead to serious losses for individuals, their families and society, and thereforesuch a disease should be worthy of being paid our much more attentions.Objective: To investigate the clinical features of cases with coronary tri-vessel diseasecombined with normal ventricular wall motion; and contrast with the ventricular wall motionabnormality cases, to explore the factors may result in normal ventricular wall motion.Methods: Screen out141cases with coronary tri-vessel disease from January1,2011to31December2011, including47patients with normal ventricular wall motion (group A), andventricular wall motion abnormalities94cases (group B) as a control. Record two groups ofpatients with clinical characteristics, combined with the Gensini score system, to deal withthe clinical factors by the overall and stratified contrast with SPSS17.0software, analyzeclinical features of coronary three-vessel disease, and the reasons that causing the differencesof these two groups.Results: The percentage of all ages of the patients were no significant difference (P=0.749). the proportions in normal wall motion group (group A) and abnormal ventricularwall motion group (B) at30-49years of age were16.6%vs.14.9%, in the50-69years agegroup, the proportions were63.8%vs.58.5%, respectively. For the composition ratio of the first time angina pectoris, in group of less than24hours of onset, the proportion of patientsin group A was larger than that in group B patients (25.5%vs10.5%,P<0.05). A comparisonof two groups’ EF value composition ratio, patients’ EF values in group A were most locatedin the normal range (76.6%vs.57.4%), while the proportion of EF value that slightlydecreased in group B was higher than normal group (35.1%vs14.9%, P<0.05). Cardiaccollateral circulation rate in group A was higher than group B in the Gensini score of100-149points (75%vs.16.7%, P<0.05); and group B had a higher smoking rates in100-149points than group A(25%vs.83.3%, P <0.05).Conclusion: For the patients of severe triple-vessel disease with cardiac collateralcirculation or non-smoking, their cardiac ventricular wall motion is more inclined to performnormal. EF values in patients with normal cardiac ventricular wall motion are more likely toshow normal.