Three-Dimensional Speckle Tracking Imaging For Evaluating Left Ventricular Strain In Patients With Different Types Of Acute Myocardial Infarction

ObjectiveThree-dimensional speckle tracking imaging(3D-STI)was used to evaluate the characteristics of left ventricular strain in patients with different types of acute myocardial infarction(AMI).MethodsSixty patients(observation group)who came to our hospital from October2018 to October 2019 and were diagnosed with acute myocardial infarction were selected.According to whether there was ST segment elevation in ECG,the patients were divided into non-ST segment elevation myocardial infarction group(NSTEMI,30 cases)and St Segment Elevation Myocardial Infarction Group(STEMI,30 cases).In addition,30 patients with acute myocardial infarction suspected of chest pain during the same period but excluded by coronary angiography were selected as the control group.All of the above patients were subjected to routine ultrasound examination.Indicators: left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),and wall motion score index(WMSI);3D-STI measurement indicators: overall longitudinal longitudinal strain of the left ventricle(GLS),global circumferential strain(GCS),and peak longitudinal strain(LS)and circumferential strain(CS)of the left ventricular segment during systole.At the same time,all of the above patients received coronary angiography(Coronary angiography),statistical analysis of peak longitudinal strain(LS),circumferential strain(CS)of the systolic period of the affected segment based on the criteria of moderate,moderate,severe,or occlusive coronary artery And other values.Results(1)There was no significant difference in height,weight,systolic blood pressure,diastolic blood pressure and heart rate between the AMI group and the control group(P> 0.05).(2)Compared with the control group,the AMI group and STEMI subgroup LVEDV,LVESV and WMSI were higher than the control group,and LVEF was lower than the control group,the difference was statistically significant(P<0.05);compared with the control group,the NSTEMI subgroup LVESV was higher than the control group,the difference was statistically significant(P<0.05),but the difference between LVEDV,LVEF,and WMSI was not statistically significant(P>0.05);compared with the NSTMI subgroup,the LVEDV and WMSI of the SETMI subgroup were higher than NSTMI The subgroup,while the LVEF was lower than the NSTMI subgroup,the difference was statistically significant(P<0.05).(3)Compared with the control group,GLS and GCS in the AMI group and its subgroups were reduced,and the differences between the groups were statistically significant(P <0.05);compared with the NSTEMI subgroup,GLS and GCS in the SETMI subgroup were not significantly different.(4)Combined with the results of coronary angiography,the left ventricular segment in the AMI group was divided into the affected segment and the normal segment.There were 163/510 myocardial infarction affected segments in the SETMI subgroup,and 99/510 in the NSTM subgroup.Compared with the control group,the LS and CS of the corresponding segment were reduced,and the difference was statistically significant(P <0.05).Compared with the NSETMI subgroup,the LS and CS of the infarct segment in the STEM subgroup were lower than NSETMI.Subgroup;the difference was statistically significant(P<0.05).(5)The correlation between LVEF and GLS,GCS.The results of Pearson correlation analysis showed that there was a significant negative correlation between LVEF and GLS,GCS(r =-0.600,r =-0.489;P <0.05).The GLS correlation is more significant.Conclusions(1)Three-dimensional speckle tracking imaging technology can non-invasively,accurately and comprehensively evaluate the strain values of the left ventricle and various segments of patients with different types of acute myocardial infarction,so as to further understand the strain characteristics of patients with different types of acute myocardial infarction and make conventional two-dimensional ultrasound Patients with no obvious abnormalities on the cardiogram can be detected early.(2)The three-dimensional speckle tracking imaging technology can further understand the location of atheromatous plaques by studying the characteristics of segmental strain values in patients with different types of acute myocardial infarction,so as to make a more accurate judgment of the affected myocardial segments.(3)There is a good correlation between the overall longitudinal strain value and the left ventricular ejection fraction,which can accurately reflect the left ventricular systolic function.