Two-dimensional Speckle Tracking Imaging Evaluates Left Ventricular Diastolic Function In Patients With Single Coronary Chronic Total Occlusion Disease With Normal Left Ventricular Ejection Fraction

Objective:Left ventricular diastolic function change in patients with single coronary chronic total occlusion（CCTO）with normal left ventricular ejection fraction was evaluated by using two-dimensional speckle tracking imaging（2D-STI）.At the same time,the feasibility of using 2D-STI to evaluate the formation of coronary collateral circulation（CCC）in such patients was also discussed.Data and Methods:The research chose 26 patients with single CCTO with normal left ventricular ejection fraction diagnosed by coronary angiography and echocardiography in our hospital（single CCTO group）and 21 healthy volunteers at the same time（normal control group）from March 2017 to August 2018.The single CCTO group was divided into poor collateral circulation group and good collateral circulation group.The indicators measured in each group included:1.Conventional two-dimensional ultrasound indicators:mitral anterior blood flow early diastolic flow velocity peak（E peak）,late diastolic flow velocity peak（A peak）,E peak deceleration time（DT）,E/A,isovolulic relaxation time（IVRT）,peak velocity of tricuspid regurgitation（TR）,mitral annulus septal and lateral early diastolic velocity e’(e’_sep and e’_lat)and E/e’_mean,left ventricular end-diastolic volume（LVEDV）and left ventricular end-systolic volume（LVESV）,LVEF,stroke volume（SV）,left atrium volume index（LAVI）.2.2D-STI indicators:left ventricular wall global systolic longitudinal strain（GSLS）,longitudinal strain during early diastole（L-Se）and longitudinal strain rate during early diastole（L-SRe）and E/L-SRe.Then the indexes’differences between single CCTO group and normal control group,poor collateral circulation group and good collateral circulation group was compared.Research result:E,e’_lat,e’_sep,E/e’_mean,IVRT,LVEDV,LVESV,SV,LVEF,LAVI and DT were lower in the single CCTO group than in the normal control group,and the difference was statistically significant（P<0.05）.The L-SRe of patients with single CCTO group was lower than that of the normal control group,and L-Se and E/L-SRe were higher than the normal control group,and the difference was statistically significant（P<0.05）.The E/L-SRe of patients with poor collateral circulation was lower than that of the good collateral circulation group,the difference was statistically significant（P<0.05）.Conclusion:2D-STI combined with other two-dimensional ultrasound-related indicators can evaluate left ventricular diastolic function change in patients with single CCTO with normal left ventricular ejection fraction.E/L-SRe has certain clinical significance for evaluating the formation of CCC in such patients.