Assessment Of Left Ventricular Systolic Function In Coronary Heart Disease Using Mitral Annulus Displacement By Speckle Tracking Imaging

BackgroundAlong with the improvement of the human living standard and diet structure change,the incidence of coronary heart disease and mortality increased year by year,and a trend of younger of patient.Among Myocardial infarction(MI), acute onset and poor prognosis and high mortality, is very critical of the type of coronary heart disease.The contractile function was weakened in nodes with infarction after MI,and the impact of left ventricular systolic function,and lead to each segment LV systolic dyssynchrony, while thus accelerated the left ventricular remodeling, causing changes in cardiac morphology and function.Therefore, accurate quantitative assessment of myocardial systolic and diastolic function in patients with CHD and regional wall function of infarction area and the ischemic area,Its have a significant clinical value in the diagnosis and treatment of coronary artery disease and myocardial infarction. The current gold standard for diagnosis of coronary heart disease is coronary angiography. But there are rays, invasive operating limitations, postoperative complications.Echocardiography because ofnon-invasive tests, good reproducibility, and simple operation,ability to accurately diagnose and assess early changes in Myocardial ischemia, has been widely used for screening suspected coronary heart disease.Speckle tracking technology(STI) is a newly developed wall motion analysis techniques to identify myocardial tissue within traceable spots echo space motion,with a high temporal resolution anwithout affecting the sound beam angle and advantages.The study applied the technique to measure the displacement of the mitral annulus in patients with coronary heart disease(MAD), aimed at finding simple and accurate new technologies, new evaluation of left ventricular systolic function parameters. ObjectiveTo evaluate left ventricular systolic function in coronary atherosclerotic heart disease patients by speckle tracking imaging(STI),to explore the feasibility of LV systolic function with mitral annular displacement(MAD). MethodsTotally 88 patients with suspected coronary artery disease were randomly selected. Based on results of coronary angiography(CAG),all patients were divided into there groups: myocardial infarction group(n = 31), angina(n = 27) and control group(n = 30).and All the apical four-chamber view and two-chamber view images were recorded.Left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV), and left ventricular ejection fraction(LVEF) were calculated by the biplane Simpson method.MAD parameters such as maximal displacement at interventricular septum(TMAD1),maximal displacement at left ventricular lateral wall(TM AD2),maximal displacement at the midpoint of interventricular septum and left ventricular lateral wall(TMAD mid), and left ventricular longitudinal shortening(TMADmid%) were defined as TMADmid divided by left ventricular end-diastolic diameter(LVIDd). The correlation between MAD index and LVEF was also explored. Results1.Compared with control groups :Angina pectoris group and MI group were not significantly different between the three groups of age, heart rate(P> 0.05). LVEDV, LVESV, LVIDd showed a tendency to increase and LVEF to decrease among the control group,Angina pectoris group and MI group,but LVEDV, LVESV and LVIDd showed no significant difference between Angina pectoris group and control group.2.The parameters of left ventricular ejection fraction angina group MAD in the normal range were lower than group,using speckle tracking measurement method for MAD evaluation of left ventricular longitudinal systolic function is impaired,and confirmed that the MAD than traditional ultrasonic Beckoning diagram method is more sensitive. The parameters of MAD were significantly lower in coronary heart disease group than those in control group.3.TMAD1,TMAD2,TMADmid,TMADmid% showed significantly positive correlation with LVEF(r=0.85,0.79, 0.84, 0.89;P<0.01). Conclusion1.There is a good correlation between the measured MAD parameters and LVEF using two-dimensional speckle tracking,the best correlation TMADmid%, the parameters can be used as a new global left ventricular systolic function evaluation index.2.Angina pectoris group LVEF in the normal range, and the parameters of angina pectoris group MAD were lower than the control group.The difference was statistically significant(P<0.01), in the light of myocardial ischemia,LVEF normal, MAD has changed,indicates that the MAD for the evaluation of left ventricular systolic function in coronary heart disease may be more sensitive, is a reliable index to evaluate left ventricular systolic function.