| Objective:1.To evaluate the clinical value of four-dimensional strain technique in the location and the quantitative analysis of myocardial infarction.2.To evaluate the left ventricular function and regional wall motion in patients with acute myocardial infarction before and after PCI by four-dimensional strain technique, and to provide reference for clinical treatment and prognosis.Methods:1.Case group:28 cases of AMI treated by PCI in our hospital were selected.inclusion criteria:(1)with ischemic chest pain clinical history,serum cardiac marker concentration more than clinical reference value and the change of progressive ECG;(2)CAG was proved to be single branch lesion in 12 patients. The lesions were divided into three subgroups: LAD artery,RCA artery and LCX artery. PCI was performed immediately on the IRA,after the intervention, the distal blood flow grade was 3;(3) The sinus rate(57-108 / min).Normal control group: Random selection of 26 cases of the same period of health physical examination, their LVEF were more than 55% and no other organic heart disease.2.All three dimensional dynamic images were stored in the control group and case group before and after one months PCI under the condition of total volume probe,enabling left ventricular dimension quantitative software analysis image, recorded EDV, ESV, EF, HR,SV and left ventricular myocardial 17 segment of the end systolic4 DLS,the color encoding bovine eye diagram was used for recording the the longitudinal strain of 17 segments,all data collected is analyzed by SPSS19.0 software.3. Analysis and compare of the clinical significance of each index comparison in case group and normal control group,to seek the early evaluation index of left ventricular function and ventricular wall myocardial function in patients with PCI. and in order to guide the clinical prevention and treatment.Results:1.Comparison of PCI in patients with acute myocardial infarction before operation and control group,Overall cardiac function decreased, LVEF value decreased, and the difference was significant(P < 0.05);The LVEF was significantly higher after one months than before PCI,and the difference was statistically significant(P < 0.05);The LVEF value of one months after PCI was still lower than that in the control group, the difference was statistically significant(P < 0.05).2.The four dimensional longitudinal strain of myocardial infarction before PCI was smaller than that in control group,the four dimensional longitudinal strain in the adjacent segments of the infarct area compensation increases and both of the difference was statistically significant(P<0.05).3.Comparison of after one months PCI and preoperative, myocardial infarction section of the four-dimensional longitudinal strain increased,the difference was statistically significant(P<0.05)4.the four-dimensional longitudinal strain of myocardial infarction segments after one months PCI is still less than the control group, the difference is statistically significant(P<0.05);the four-dimensional longitudinal strain decreases in the adjacent segments of the infarct area compensation,there was no significant difference between normal group and control group(P > 0.05).Conclusions:1.PCI is an active and effective treatment for acute myocardial infarction,and the overall cardiac function and regional myocardial infarction in patients were significantly improved after PCI.2. Four dimensional strain technique can accurately measure the left ventricular function,and locate and quantitatively analyze the location and extent of myocardial infarction.3.Myocardial longitudinal strain and CAG assessment of myocardial infarction segment is consistent.4.Myocardial motion in myocardial infarction segment decreased, and adjacent segment ventricular wall motion compensated enhancement. one months after PCI, the compensatory segment tended to be normal, but the myocardial infarction segment was not fully recovered. |
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