Evaluation Of The Clinical Value Of Speckle Tracking Echocardiography For The Early Diagnose Of Myocardial Ischemia

Background With China's population is ageing and improvement of living standards, the incidence of coronary heart disease is higher. How to early diagnosis coronary heart disease has become the focus of cardiovascular disease research. STI technology track the speckles of myocardial in two-dimensional and calculate spots's position changes in all directions ,the motion parameters can be used to evaluate the whole and partial function of left ventricular. Recent studies show that STI technology with high sensitivity and specificity for myocardial ischemia. For left ventricular systolic function, the overall evaluation measurement method are two-dimensional Simpson and M type, both the two have certain limitations. M type with local function represents the whole function, and two views of the two-dimensional Simpson (apical 2-chamber,apical 4-chamber)are from two different cardiac cycle .Objective To evaluate the clinical value of speckle tracking echo- cardiography for the measurement of the global and regional myocardial strain of the left ventricle in coronary heart disease patients ; LV ejection fraction(EF) was calculated by Tri-plane method and the correlations between Tri-plane EF and GLS-Avg were analyzed.Methods Study population consisted of 29 healthy subjects and 29 coronry heart diease patients proved by selected coronary angiography including single lesion in 14 cases ,double lesion in 8 cases and three lesion in 7 cases ,The high frame rate two-dimensional loop-cinec were recorded in long axis of left ventircle view, in apical 4-chamber view and in apical 2-chamber view. Eighteen segments of LV longitudinal peak systolic strain and global peak systolic strain of each view were measured by automated functional imaging(AFI). LV ejection fraction(EF) was calculated by Tri-plane method.Values were compared between the two groups ,the correlations between Tri-plane EF and GLS-Avg were analyzed.Result Left ventricle longitudinalpeak systolic strain of control group were gradually increased from basal segment to apical segment ,There are statistically difference between the apical segments and basal segments, middle segment of every left ventrical wall. (P<0.05),but the difference between each wall wasn't significant (P>0.05),the time to peak-tw of every segmeng is consistent. Left ventricle longitudinal peak systolic strain of CHD group wasn't gradually increased in some segments ,there was significant difference among several segments in CHD group (P<0.05),All parameters of S,GLS-A2C,GLS-LAX,GLS-A4C and GLS-Avg were significantly higher in the contyol group than those in the CHD group(P<0.05), The GLS-Avg of the three lesion,the double lesion and the single lesion were gradually decreased.the time to peak-tw of every segment is not consistent,The GLS-Avg correlated significantly with Tri-planeLVEF (r=0.92).Conclusion Speckle tracking echocardiogyaphy could be used quantify the globe and regional myocardial strain of left ventricular, it is an important method to diagnose earlymyocardial ischemia;The GLS-Avg correlated significantly with Tri-planeLVEF .