Assessment Of Left Ventricular Remodeling And Function In Patients With The Severity Of Coronary Artery By Using RT-3DE

Objective:To explore the accuracy and reliability of real-time three-dimensional in value left ventricular remodeling and function in patients with the severity of coronary artery, and the clinical value of left ventricular remodeling index in value left ventricular remodeling.Materials and Methods:Fifty-four patients and fifteen healthy people were included in the study. The objects were divided into 4 subgroups acco rding to The Gensini score:normal control group(0 score), Mild lesions (< 25 scores), Moderate lesions (range 25 to 49 scores) and Severe lesions (≥5 0 scores). All subjects were examined by MME,2DE and RT-3DE separat ely. Left ventricular end-diastolic volume (LVEDV), left ventricular end-sys tolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular mass(LVM),left ventricular mass index(LVMI), left ventricular end-diastolic volume index (LVEDVI) and left ventricular remodeling index (LVRI) were measured. Comparing the differences among in the groups and within the th ree methods above, and evaluated the correlations between the values of CH D patients and Gensini scores.Results:1 CHD and Normal groups No differences between mild lesions and normal control group among the value obtained by MME,2DE and RT-3DE (P>0.05),but significant differences are founded between moderate, severe lesions groups and normal groups (P<0.05), except LVM measured by RT-3DE.2 Comparison between CHD groups The LVEDV, LVESV, LVM, LVE DI, LVMI are greater in moderate and severe lesions groups than in mild gr oup, and increased with the severity of coronary artery lesions, but reduced in the LVEF and LVRI. There are differences among the CHD groups in LV EDV, LVESV, LVEF, LVEDI, LVRI obtained by these methods (P<0.05); The LVM,LVMI were founded differences between severe lesions and norm al groups, while between Moderate and severe lesions groups only be found ed by RT-3DE measured (P<0.05)3 Comparing one to another method in CHD groups All values have no difference in mild lesions groups obtained by MME,2DE and RT-3DE (P> 0.05). In moderate and severe lesions groups the LVEDV, LVESV, LVM, LVEDI and LVMI measured by MME are higher than 2DE and RT-3DE, but LVEF, LVRI are smaller. For LVEDV, LVESV, LVEDI in Moderate and severe lesions groups, LVMI in Moderate lesions groups and LVRI in severe lesions groups, there are differences between MME and 2DE, RT-3DE (P<0.05).However, compared 2DE and RT-3DE,only LVESV is different (P<0.05)4 Correlation analysis All parameters measured by MME,2DE and RT-3DE have good correlations with Gensini scores, Meanwhile the correlation between RT-3DE and Gensini scores is the best but poorest between MME and Gensini scores. Compared with LVMI and LVEDI, LVRI has the greatest correlation with Gensini scores by MME,2DE and RT-3DE(r=-0.723, -0.810, -0.886) vs LVEDI(r=-0.723,-0.810,-0.886,) and LVMI (r=0.326,0.449,0.526).Conclusion:1 Left ventricular remodeling and function declined closely associated with the severity of coronary in patients with Coronary Heart Disease. Left ventricular remodeling and function aggravated with the severity of coronary artery disease.2 Compared with MME and 2DE Simpson’s methods, RT-3DE is more accurate and reliable to reflect the left ventricular remodeling and function when the shape of the heart has changed.3 LVRI is a nicer parameter than only using LVEDI or LVMI in evaluating left ventricular remodeling.