Relationship Between Left Ventricular Remodeling Of Patients With Coronary Heart Disease Evaluated By Real-time Three-dimensional Echocardiography And Severity Of Coronary Artery Stenosis

Objective This study was designed to evaluate left ventricle remodeling ofpatients with coronary heart disease by Real-time three-dimensionalechocardiography, and to explore the relationship between leftventricle remodeling and severity of coronary artery stenosis.Methods59cases of coronary heart disease patients treated in Department ofCardiology of our hospital were selected from September2010to April2011,35males and24females, aged40~78(53.13±10.47) years old,including22cases of myocardial infarction and37cases of patientswith angina pectoris. According to Gensini score,59cases of patientswith coronary artery disease and24normal cases were divided intomild lesions group (<25points), moderate lesions group (25～49points), severe lesions group (>50points) and normal control groupfour groups, Real-time three-dimensional echocardiography was usedto measure its left ventricular end-diastolic volume(left ventricularend-diastolic volume, LVEDV), left ventricular end-diastolic epicardialvolume(left ventricular end-diastolic volume epicardial, LVEDVepi),left ventricular end systolic volume (left ventricular end systolicvolume, LVESV), left ventricular ejection fraction (left ventricularejection fraction, LVEF), left ventricular myocardial quality(LVM), left ventricular remodeling index(left ventricular remodeling index,LVRI) respectively. Relevant differences were analyzed and compared,and correlation analysis was performed between relevant leftventricular remodeling measured values and Gensini score.Results1. Compared with normal control group, gender, age, smoking, bodymass index in each group of patients with coronary heart diseaseshowed no significant difference (P>0.05).2. Compared with normal control group, the LVEDV, LVESV, LVM oflesions groups with coronary artery disease were all larger thannormal control group(P<0.05or P<0.01), LVEF、LVRI were both lessthan normal control group(P<0.01).3. Compared with mild lesions group, the LVEDV, LVESV of moderatelesions group and severe lesions group were all larger than mildlesions group (P<0.01), LVEF、LVRI were both less than mild lesionsgroup (P<0.01).4. Compared with moderate lesions group, the LVEDV, LVESV of severelesions group were all larger than moderate lesions group (P<0.01),LVEF、LVRI were both less than moderate lesions group (P<0.01).5. With the aggravation of the extent of coronary artery stenosis, LVEDVand LVESV were both progressive increasing(P<0.05or P<0.01),LVEF and LVRI were both progressive reducing(P<0.01).6. LVEDV, LVESV, LVEF and LVRI all had good correlation withGensini score, LVEDV, LVESV, LVM had positively correlation withGensini score(r=0.82,0.86,0.34, P<0.01,0.01,0.05) and LVEF, LVRIhad negatively correlation with Gensini score (r=-0.82,-0.83, P<0.01), LVM and the Gensini score was no significant correlation. Conclusion1. Left ventricular remodeling occurred in patients with coronary heartdisease，the efficient determination of left ventricular remodelingindex had very important clinical significance on patients of coronaryheart disease, especially acute myocardial infarction in diseaseprogression, prognosis and treatment evaluation.2. Real-time three-dimensional echocardiography can evaluate leftventricle remodeling of patients with coronary heart disease effectively.RT-3DE had good correlation with The "gold standard" of MRI.Ultrasound features of RT-3DE evaluation of left ventricularremodeling is manifested as the LVEDV, LVESV, LVM increase andLVEF, LVRI decreases.3. Left ventricular remodeling associated with the severity of coronarylesions on each other, influence each other and promote each other;from micro to macro, the extent of left ventricular remodeling isaggravated with the severity of coronary artery disease.4. LVRI a simple coefficient to distinguish between left ventricularremodeling and pathological remodeling, quantitative assessment ofleft ventricular remodeling in different pathological conditions, thedegree can be used clinically as a new index for evaluation of leftventricular remodeling.