The Study Of The Left Ventricular Global And Regional Function In Patients With Coronary Arteries Stent Intervention By Real-time Three Dimensional Echocardiography

Objective:The global and segment systolic function of the left ventricle in patient with coronary heart disease were demonstrated on Real-time three dimensional echocardiogram(RT-3DE) so as to assess the global and segment systolic function of the left ventricle in patient pre- and post- coronary arteries stent intervention.Materials and Methods:1 Object:25 cases with coronary arteriosclerosis heart disease(CHD) were inpatients in the 3rd Hospital of Hebei medical university since December, 2008 to November, 2009., of which there were 15 male and 10 female. The rate of stenosis of coronary artery was≥75% on coronary arteriongraphy. The coronary arteries stent intervention had been done in all cases. The 20 healthy cases were for comparison, of which 16 male and 4 female. No symptome of the coronary heat disease were appeared in the group.2 Methods:The real-time three dimensional echocardiography(RT-3DE)ultrasound apparatus of Phillips IE33 with 1-3MHz matrix transducer and QLAB Software were applied to exam all cases. The electrocardiogram (ECG) was showing at the same time.The groups of the coronary heart disease (pre-and post- coronary arteries stent intervention) and healthy volunteers were examined by RT-3DE. The RT-3DE images were documented. The quantitative analysis for these images was performed by Qlab and the volume-time curves of the global and 17 regional LV were noted. Then, the regional end-diastolic volume (REDV), the regional end-systolic volume (RESV), the regional stroke volume (RSV) and the regional eject fraction (REF).were calculated. The values of the pre- , post- coronary arteries stent intervention and healthy group were studied.3 Statistics: The SPSS 13.0 statistics software was used to analyze all cases, and the results were used mean±standard deviation(SD) of methods. A paired t-test was used to compare inter-groups variables. A value of P<0.05 or P<0.01 was considered statistically significant.Results:1 The"U"shaped and regular curves were documented in the left ventricle 17 regional volume curves of the comparison group. The 17 regional volume values were decreasing from base to apex of LV, basal>mid>apical. Whereas, the 17 regional volume curves in patients with CHD were irregular, scattered and overlapped. The smallest regional volume curves were demonstrated in the ischemic region of LV.2 The LVEDV and LVESV were significantly higher and the LVEF lower in CHD than comparison group (p<0.05). The LVEDV,LVESV were decreasing in post- than pre-coronary arteries stent intervention and the EF were normal(p<0.05).3 The REF was increasing from base to apex in comparison group. The smallest REF in basal septic wall and the largest REF in the apical inferior wall were noted (p<0.05). Thereby, the myocardium constriction was gradually were increasing from basal to apex. The constriction of ventricular-septum was weaker than free-wall including inferior,lateral,anterior wall. The REF in most region of CHD were lower than those in normal group, especially in the anteroseptum,anterior,posterior and apical inferior wall(p<0.05 or p<0.01).The REF in post- coronary arteries stent intervention group were increasing than pre-group, the most of them reached normal. The P of REF in anteroseptal,anterior,posterior and inferior was <0.05.Conclusions:1 The quantitation of global volume of LV and heart function were calculated exactly on RT-3DE than 2DE. The accurate information for the diagnosis of CHD was provided by RT-3DE because of the 3-D heart constitution showing on the RT-3DE.2 The quantitative study for the global and regional left ventricle volume and function on RT-3DE were analyzed more exactly in local or segment, so as to match the branches of coronary artery. It was more useful in diagnosis of CHD.3 After the coronary arteries stent intervention, the left ventricular myocardium reconstruction was improved, the left ventricular segment volume and systolic function were assessed by RT-3DE objectively. In the clinical practice RT-3DE should be a new method in assessing the regional left ventricular function and studied further.