The Study Of Left Ventricular Wall Motion And Systolic Function In Patients Of Coronary Artery Disease With Myocardial Ischemia Of Various Degree By Echocardiography

[Background and objective] Left ventricular systolic function (LVSF) is an important index to determine the long-term prognosis of patients with coronary artery disease (CAD) . The CAD patients with normal or nearly normal LVSF often have better prognosis, on the contrary, the mortality of CAD patients with severely injured LVSF will increase when they are undertaking drug therapy or interventional therapy, such as coronary artery bypass graft (CABG) and percutanueous transluminal coronary angioplasty (PTCA). Therefore, assessment of LVSF is of vital importance in patients with CAD. Various methods have been introduced to achieve this goal but a noninvasive method, echocardiography, is more appropriate. In echocardiography, three methods (M mode echocardiography, Simpson method and AQi method) can be used to detect the left ventricular ejection fraction (LVEF), which reflects the LVSF. The aim of this study is to assess the practicable value of the three echocardiography methods (M mode echocardiography, Simpson method and AQi method) in CAD patients, especially in patients with regional wall motion abnormality.[ Methods ] All the cases were detected with two dimensional echocardiography (2DE), intelligent acoustic quantification(AQi) and color kinesis(CK) by Philips HP5500 (with S4 probe and AQi software). The examination and assessment standards are as follows: left ventricular ejection fraction (LVEF), using three echocardiography methods (M mode echocardiography, Simpson method and AQi method), assessing the condition of left ventricular wall by 16 regional wall motion score index and color kinesis.Statistical analyses: LVEF detected by three echocardiography methods were completed through t-test and paired t-test with SPSS for Windows version 11.5. LVSF of all the patients were assessed by LVEF detected by three echocardiographymethods.[Results] In the control group and the group of CAD patients with coronary artery stenosis 51-75%, the LVEF difference between M mode echocardiography and Simpson method, AQi method was not significant (P>0.05). In the group of CAD patients with coronary artery stenosis>75%, the LVEF difference between M mode echocardiography and Simpson method, AQi method was significant (P<0.01); the LVEF difference between Simpson method, AQi method was not significant (P> 0.05).In CAD patients with regional wall motion abnormality, the LVEF difference between M mode echocardiography and Simpson method, AQi method was significant (P<0.01); the LVEF difference between Simpson method, AQi method was not significant (P>0.05). The LVEF values detected by these three methods are as follows: (M mode: 56.66?.40%,Simpson method: 50.76?.30%, AQi method: 50.45 6.58%) . In the CAD patients with regional wall motion abnormality, there was a linear correlation between the LVEF (detected by three echocardiography methods) and the left wall motion score index (WMI). Furthermore, the relativity of the WMI-LVEF detected by Simpson method and the WMI- LVEF detected by AQi method are better than the WMI- LVEF detected by M mode echocardiography. The correlation coefficient are as follows: WMI-M mode: 0.690; WMI-Simpson method: 0.795; WMI-AQi method: 0.734.Conclusions In patients of coronary artery disease without regional wall motion abnormality, the left ventricular ejection fraction detected by three echocardiography methods (M mode, Simpson method and AQi method) accurately reflects the left ventricular systolic function and M mode is more simple and convenient than the other two. However, in patients with regional wall motion abnormality, the left ventricular ejection fraction detected by Simpson method and AQi method reflects the left ventricular systolic function more accurately than that detected by M mode. Therefore, we should use Simpson method or AQi method to assess the coronary artery disease patients with regional wall motion abnormality forthese two methods can estimate the left ventricular systolic function accurately and impersonally.