| Objective 1.To assess strain changes before and 3 days after percutaneous coronary intervention in patients with acute myocardial Infarction by left ventricular short axis two-dimensional speckle tracking imaging in different directions.2.To evaluate the in-hospital effectt of emergency percutaneous coronary intervention on patients with acute myocardial infarction.Methods 29 cases of acute myocardial infarction with average age of 66.6±10.6 years old underwent emergency percutaneous coronary intervention between June ,2008 and February ,2009. Exclution previous myocardial infarction,diabetes mellitus(DM), salvage interventional therapy,Severe valve disease,severe hypertensive heart disease(HHD), congenital heart disease(CHD),poor quality LV images,et al. Diagnose and determin indication, operation,effect,complication according to the guideline of Percutaneous Coronary Intervention(PCI) made by American College of Cardiology/American Heart Association(ACC/AHA)/SCAI.Left ventricular ejection fraction and radial strain, circumferential strain , rotation angle was evaluated with two-dimensional echocardiography apical biplane reducing Simpson's and left ventricular short axis view speckle tracking imaging before and 3 days after PCI. Analyze the data with statistics method.Results 1. Of all patients, 1-vessel disease was present in 13(44.8%), 2-vessel disease in 11(37.9%), and 3-vessel disease in 5 patients(17.2%).There are 45 infarction related artery totally,in which 21 anterior desending branch (46.7%),13 circumflex branch(28.9%),11 right coronary artery(24.4%).All had successful operation.2.Mean value of radial strain,circumferential strain,rotation angle,left ventricular ejection fraction before PCI were all lower than normal value, where there was remarkable difference(all of P<0.05). Radial strain,circumferential strain,left ventricular ejection fraction after PCI were all higher than before(all of P<0.05). But there was no significant difference in rotation angle before and 3 days after PCI( P>0.05). Mean value of all index were still lower than normal value after PCI. (all of P<0.05).3.Mean value of left ventricular ejection fraction in patients with 1-vessel disease was higher than patients with 2-vessel disease and 3-vessel disease before and 3 days after PCI(all of P<0.05).4.Improvement rate of radial strain,circumferential strain in group with left ventricular ejection fraction improved were remarkable higher than another(all of P<0.01). But there was no significant difference in rotation angle between two(all of P>0.05).Conclusions 1. Regional systolic function damaged because of myocardial ischemia in patients with acute myocardial infarction. Mean value of radial strain. Circumfer- ential strain.rotation angle.left ventricular ejection fraction were all degraded. 2. Strain and rotation angle can reflect abnormal regional systolic function sensitively while left ventricular ejection fraction is still in the normal range. 3. Percutaneous coronary intervention can relieving infarction related artery ,recover global and regional systolic function.Then strain,left ventricular ejection fraction and rotation angle increased.4.Glober systolic function is associate with regional systolic fuction tightly. 5. Regional wall motion of left ventricule can be evaluated accurately and sensitively with two-dimensional speckle tracking imaging. |
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