Evaluation Of Early Efficacy At Post-Percutaneous Coronary Intervention In Patients With Chronic Total Coronary Occlusion By Myocardial Contrast Echocardiography And Two-Dimensional Speckle Tracking Imaging

Objective:To investigate the value of two-dimensional speckle tracking imaging and myocardial contrast echocardiography in the evaluation of early left ventricular recovery after percutaneous coronary intervention(PCI)in patients with chronic total occlusion(CTO).Methods:A total of 3 patients with CTO lesions who underwent PCI revasculariXation in our hospital from September 01?to ecember 01?were enrolled.conventional two-dimensional echocardiography two-dimensional speckle tracking imaging and myocardial contrast echocardiography were performed within?hours before and after PCI revasculariXation on them ac uiring and saving images measuring and calculating the following parameters E-peak velocity and A-peak velocity of mitral valve diastolic e peak velocity of Mitral annulus at interventricular septal side(e′_S)and lateral wall side(e′_L)using tissue oppler e E/e ratio left ventricular wall motion score inde(WMSI)left ventricular end-diastolic volume(LVE V)left ventricular end-systolic volume(LVESV)left ventricular eMection fraction(LVE).among them LVE V LVESV and LVE were measured by using simpson′s biplane method in myocardial contrast echocardiography.Analysis the images on Qlab workstation and get the left ventricular global longitudinal strain(GLS)the left ventricular myocardial perfusion score inde(PSI)the myocardial contrast time-intensity curve at pre-PCI and post-PCI.The peak signal intensity of the plateau phase(A)the filling rate of contrast medium in each myocardial segment(β)and the regional myocardial blood flow per second(A·β).Then all of above parameters were compared between the pre-PCI and post-PCI.According to the CTO lesions in different coronary vessels were repatency the patients were divided into three groups left anterior descending(LA)group right coronary artery(RCA)group and left circumfle artery(LCX)group regional myocardial longitudinal strain(RLS)and regional myocardial perfusion(PSI AβA·β)at pre-PCI and post-PCI were calculated and compared respectively.Results:At post-PCI E-peak velocity and A-peak velocity of mitral valve e _S e e _L E/e ratio LVE V LVESV LVE WMSI were not statistically different from those before PCI.The post-PCI PSI was significantly lower p<0.0001 the difference between pre-and post-PCI was statistically significant.The GLS AβA·βwere significantly increased compared with pre-PCI p values were<0.001 0.040 0.0440.003 respectively the difference was statistically significant.Among the three groups of patients in the LA group RCA group and LCX group the RLS PSI AβA·βof each coronary artery donated area were significantly improved compared with the pre-PCI p values were all less than 0.05 the difference were Statistical significance.Conclusions:PCI revasculariXation can improve myocardial perfusion and myocardial motor function in patients with CTO lesions.Both myocardial contrast echocardiography and two-dimensional speckle tracking imaging can evaluate the improvement early and uantitatively and can simultaneously evaluate the left ventricular global and regional myocardium perfusion changes and strain changes both of these two new echocardiographic techni ues can be used for early efficacy evaluation of PCI revasculariXation and have uni ue application value in the follow-up and efficacy evaluation of patients after PCI.