Evaluation On The Change Of Cardiac Function In The Patients With Non-st Segment Elevation Acute Coronary Syndrome By Ultrasonic Three Dimensional Speckle Tracking Technique

Objective: To investigate the difference among the patients with non-ST-segme nt elevation acute coronary syndrome(NSTE-ACS)before and after percutaneo us coronary intervention and the non CHD patients by using the three-dimensi onal speckle tracing echocardiography and to analyze the correlation between the coronary angiography and the 3D-STI outcomes.To explore the clinical application of this technique in evaluating the cardiac function of patients with NSTE-ACS.Methods: To collect 62 cases which were ruled out the diagnosi s of CHD by coronary angiography as control group.A total of 137 NSTE-A CS patients were enrolled in the study group.Among them,57 patients with a cute non-ST-elevation myocardial infarction(NSTEMI)and 80 pat-ients with u nstable angina(UAP)were enrolled in Tianjin Chest Hospital.To get Left ven tricular global longitudinal strain(LVGLS),Left ventricular global circumferentia l strain(LVGCS),Left ventricular global radial strain(LVGRS),Left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF)by 3D-STI,meanwhile got Left ventricular end systolic dimension(LVESD)?Left ventricular end diastolic dimension(LVE DD)?Left ventricular posterior wall thickness(LVPWT)interventricular septum thickness(IVST)?E/A by conventional ultralsound,all patients underwent coron ary angiography(CAG),NSTE-ACS patients underwent percutaneo-us coronary i ntervention(PCI).We collect general clinical characteristics of all inclusive patie nts including body mass index(BMI)? smoking Hypertension Diabetes CHD fa mily history and clinical biochemical index including NT-pro BNP,c Tn T,CK,C K-MB,high sensitivity C-reactive protein(hs-CRP)and so on.All the patientsa fter PCI were followed up for an average of 3 to 6 months.We observed thep atient’s blood assay index and ultrasonic index changes and recorded the result s of the occurrence of major adverse cardiovascular events.The ultralsound pa rameters and serological results were analyzed.If the parameters were compare d by Dunnett-t test and multiple groups was based on one-way ANOVA.Thethree-dimensional speckle parameters are compared with left ventricular ejection fraction using Pearson correlation analysis.The paired-samples T test was used in the study group before and after PCI.Results: 1.Conventional ultrasonic parameters LVESD,LVEDD,IVST,LVPWT in NSTEMI group than UAP group and control group were significantly increa sed,LVEF significantly decreased and differences were statistically significant(P<0.05).E/A in NSTEMI group than control group was obviously decreas ed and difference was statistically significant(P<0.05).LVGLS,LVGCS,LVEF were significantly lower in the NSTEMI group than in the control group and UAP(P<0.05),and LVGRS was significantly lower only than control group(P<0.05),while LVESV was obviously increased in NSTEMI group than that in control group and UAP group(P<0.05).LVGLS,LVGCS,LVGRS were significa ntly lower in the UAP group than in the control group(P<0.05),while LVED V,LVESV,LVEF were similar in UAP group and the control group(P>0.05).2.LVGLS,LVGCS,LVESV,NT-pro BNP,hs-CRP,c Tn T and LVEF were negatively correlated,and LVGLS and LVEF were more obvious,while LVGRS,LVEDV and LVEF were not found to be correlated(P>0.05).3.LVGLS,LVGCS,LVEF in the three-vessel disease group and double-vessel di sease group were significantly lower than that of single-vessel disease group(P <0.05),and LVGLS and LVEF were significantly lower in the three-vessel dis ease group than that in the double-vessel disease group(P<0.05).LVGRS o-nl y in the three-vessel disease group was significantly lower than the single-v--es sel disease group(P<0.05),in the other groups without statistical difference(P>0.05).LVESV was obviously increased in three-vessel disease and double-vesse l disease group than that in the single-vessel group(P<0.05).4.LVGLS,LVGCS,LVGRS,LVEF in UAP group and the NSTEMI group were significantly increased after PCI,while LVESV? LVEDV in the two groups af ter PCI was significantly reduced(P<0.05).LVGLS,LVGCS,LVEF in the group o f single-vessel disease group,double-vessel disease group and the three-vessel disease group were significantly increased after PCI,LVGRS was in the three-v essel disease group and double-vessel disease group obviously increased afterPCI(P<0.05).LVESV,LVEDV in the double-vessel disease group and three-vessl disease group were obviously reduced(P<0.05),while the single-vessel disease group were not obviously reduced(P>0.05).Conclusions: 1.3D-STI ultrasound compared the Conventional ultrasonic could evaluate the g lobal and local cardiac function of NSTE-ACS patients in an objective,effecti-v e,comprehensive and quantitative manner,Which has a certain clinical applicati on value.2.PCI can significantly improve the cardiac function of NSTE-ACS patients and improve prognosis,3D-STI ultrasound can evaluate the effect of PCI effecti vely.3.LVGLS,LVGRS,LVGCS parameters are significantly improved in patients with NSTE-ACS.Among them,LVGLS is more sensitive than other parameter s in evaluating the change of cardiac function.4.3D-STI ultrasound can evaluate coronary ischemia well.