Investigation Of3D-STI For The Assessment Of Left Ventricular Regional Function And Diagnostic Value Of CHD

Objective:Investigate the feasibility of Three-Dimensional Speckle Tracking for Assessment of Left Ventricular Regional Function of Patients with Different graded Coronary Artery Stenosis and diagnostic value for coronary heart disease.Materials and methods:110patients who were doubt of CHD in the Beijing Hospital of the Ministry of the Health were selected from June,2010to Aug,2012. Men68, women42, average age (63.2±8.9) years. Exclude standard:arrhythmia; history of old myocardial infarction or underwent PCI; heart failure; the heart disease of cardiomyopathy, severe valvular heart disease, or congenital heart disease; the quality of the3D imaging is so poor that can’t be analyzed. All patients were received the examination of regular and three dimensional echocardiography before the CAG, collected and stored the three dimensional all volume dynamic cardiac graph. Analyzed the3D dynamic graph using the3D-STI offline, then could get the various peak strain value(include RS,CS,LS,AS) and the time of the peak strain(include T-RS,T-CS,T-LS,T-AS) of the16myocardial segments of the left ventricle(consist of6segments on the level of mitral orifice,6segments on the level of papillary muscles and4segments on Apex section). According to the results of the CAG, divided the subjects into5groups:normal group(stenosis extent=%); slightly narrowed group (0%<stenosis extent≤25%); mild narrowed group (25%<stenosis extent≤50%); moderate narrowed group (50%<stenosis extent≤75%); severe narrowed group (stenosis extent>75%). Using statistical software of SPSS16.0to compare the peak strain value and the time of the peak strain in different graded coronary artery stenosis, investigate the feasibility of3D-STI for assessment of left ventricular regional function of patients with different graded coronary artery stenosis. Analyze the sensitivity and specificity of the above strain variables for the CHD and discuss the value of identification for CHD with3D-STI.Results:In different grade coronary artery stenosis groups, the peak strain value of part of the myocardial segments corresponded to the lesion vessel were descending, while the time of the peak strain were ascending along with the increasing of the grade of setenosis, especially on the severe narrowed group. The composite index of LS has the best identified value for the CHD, the sensitivity was61.8%, the specificity was76.2%. Then in sequence the identified value were composite index of AS>T-LS> composite index of CS.Conclusion:3D-STI is feasible for assessment of left ventricular regional function of patients with different graded coronary artery stenosis and has certain diagnostic value for CHD. These provide some supports for the diagnosis of CHD by noninvasive technique.