The Early Evaluation And Study Of The Left Ventricular Myocardial Strain Function In Coronary Heart Disease Patients Using Speckle Tracking Imaging

BACKGROUND:Coronary heart disease(CHD),also known as ischemic heart disease (IHD),is the commonest heart disease among the middle-aged people and the elderly and its death rate is the highest. At present, coronary angiography (CAG) is widely thought as the gold standard for the diagnosis of CHD, but limitations such as invasive, radiating, high cost and high technical requirements exist. Myocardial strain is the systolic and diastolic myocardial formability, indicating myocardial systolic function directly. Speckle tracking imaging(STI) is a newly developed technique in Ultrasonic medicine, with the ability to track each speckle and describe its motion route, so as to quantitatively analyze the motion speed, strain and strain rate of myocardial tissue, evaluating its systolic ability, providing a better and noninvasive modality for the early diagnosis of CHD.PURPOSE:To quantitatively analyze the longitudinal and radical strain of left ventricular using speckle tracking imaging (STI) in CHD patients, evaluating the change discipline of LV myocardial strain, discussing the clinical application value of STI in the early diagnosis of myocardial ischemia.METHODS:Fifty-nine patients with clinical proved CHD and thirty-three healthy subjects were enrolled. The former served as an experiment group, while the later served as a control group. High frame rate two-dimensional (2D) images were recorded from GE Vivid-E9Dimension the left ventricular apical two-, three-and four-chamber views, as well as left ventricular short-axis views at the levels of mitral annulus, papillary muscle and apex. Longitudinal strain (LS), radical strain (RS), and circumferential strain (CS) were measured by using GE Echo PAC software. Results were analyzed using SPS16.0statistical software. Statistically significant difference was found only when P<0.05.RESULTS:LS values gradually increased from the basic segment to the apical segment and LS values of the basic segment were significantly decreased than the middle and apical segment in the control group (T<0.05).RS values were almost the same in different segments of the same level, while RS values of the same papillary muscle segment was higher than the mitral valve annulus and the apical segment (P<0.05).There were no significant difference in CS values between different levels and segments. Compared to the control group, LS,RS,CS values in every segment all decreased, and the average strain of each level significantly decreased (P<0.05).LS values in anterior septal of basement、septum and anterior septal of middle segment、apical segment except septum all significantly decreased (P<0.05).RS values in posterior wall、inferior wall、anterior septal of the mitral valve level, inferior wal1、posterior wal1、anterior septa1、lateral wall of the papillary muscle level, inferior wall、septum、anterior septal of the apex cordis level all significantly decreased (P<0.05).CS values in posterior wal1、 septum、anterior septal of the mitral valve level, anterior wal1、lateral wal1、anterior septal of the papillary muscle level, apex cordis level besides lateral wall all significantly decreased (P<0.05).CONCLUSIONS:The regional systolic function had been decreased while no segmental wall motion abnormal in patients of coronary artery disease. It is demonstrated that STI have great values in quantitatively analysis regional wall function of left ventricular, which is helpful in the early diagnosis of left ventricular function in patients of coronary artery disease.