| Objective Coronary atherosclerotic heart disease(CAD)was a cardiovascular disease with relatively high incidence in clinical.The patients were easily ignored due to its insidious onset and relatively mild early clinical symptoms and signs.It was always the focus and difficulty for ultrasound doctors to make the clinical diagnosis of non-organism trauma and quantification in the early stage of CAD patients.At present,conventional echocardiography,echocardiography,tissue Doppler and coronary angiography(CAG)were mostly used to evaluate the severity of CAD patients,but the above methods had shortcomings.2D secular tracing imaging(2D-STI)technology was a new ultrasonic diagnostic technology.Therefore,this study intends to observe2D-STI technology to evaluate the changes of left ventricular systolic physiological function in CAD patients and explore its clinical application value in early diagnosis of coronary artery stenos is in CAD patients.Methods 66 patients which were clinical suspected diagnosis of CAD were selected as the research object,and these patients were divided into mild lesion group(group A,the Gemini score< 25 points,n=24 cases),moderate lesion group(group B,25 points≤ the Gensinis score≤49 points,n=22 cases)and severe lesion group(group C,the Gensinis score>50 points,n=20 cases)according to the Gensini score.At the same time,25 cases of CAD patients without pathological changes of coronary artery stenosis were selected as the control group.The left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)of each group were detected by conventional ultrasound electrocardiogram.Then,the left ventricular ejection fraction(LVEF)of all patients were measured by simpson test.The systolic longitudinal strain peak,systolic peripheral strain peak and systolic radial strain peak of each ischemic myocardium segment at the basal segment of the left ventricle,the middle segment,and the apex segment of each group were detected by2D-STI.The area under the curve(AUC)of the overall strain value of the left ventricle was calculated by using the ROC curve,and the value of the overall strain value of the left ventricle in the diagnosis of severe coronary artery lesions was analyzed.Results There was no significant difference in clinical data and lipid-related indicators between CHD patients and control group(P>0.05).There was no significant difference in the related parameters of routine echocardiography such as LVEDD,LVESD,LVEDV,LVESV,LVEF between coronary heart disease groups and the control group(P>0.05).The peak shrinkage longitudinal strain of left ventricular basal segment,middle segment and apex segment of all groups compared had a significant difference(P<0.05).The peak shrinkage longitudinal strain of left ventricular basal segment,middle segment and apex segment of group C was significantly lower than that of control group and group A(P<0.05).The peak shrinkage longitudinal strain of left ventricular basal segment,middle segment of group C was significantly lower than that of group B(P<0.05),the peak shrinkage longitudinal strain of apex segment of group B was significantly lower than that of control group(P<0.05),but there was no significant difference in the peak shrinkage longitudinal strain of left ventricular basal segment,middle segment and apex segment between group A and the control group(P>0.05).There was no significant difference in the peripheral strain peak of the left ventricular basal segment and middle segment among the all groups(P>0.05).There was a significant difference in the peak of peripheral strain during apical systolic period among the all groups(P<0.05).The peak shrinkage circumferential strain of left ventricular basal segment,middle segment and apex segment of group C wassignificantly lower than that of control group(P<0.05),the peak shrinkage circumferential strain of middle segment and apex segment of group C was significantly lower than that of group A(P<0.05),the peak shrinkage circumferential strain of apex segment of group C was significantly lower than that of group B(P<0.05).There was no significant difference in the peak shrinkage circumferential strain of left ventricular basal segment,middle segment and apex segment between group A,group B and control group(P>0.05).There was no significant difference in the peak radial strain during shrinkage of the left ventricular basal segment,middle segment and apex segment among the all groups(P>0.05).The AUC,diagnostic sensitivity and diagnostic specificity of the peak shrinkage longitudinal strain of each ischemic myocardium segment predicted of patients in group C were significantly better than that of peak shrinkage circumferential strain and peak radial strain during shrinkage(P<0.05).Conclusion The contractile motor function of myocardial ischemia segment of the CAD patients which left ventricular segmental wall movement with no obvious abnormal decrease in different degrees.2D-STI ultrasonic imaging technology can be used to quantitatively evaluate the left ventricular systolic motor function of CAD patients,which is helpful for medical staff to evaluate the severity of coronary artery stenosis. |
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