A Study Of Real-time Three-dimensional Echocardiography For The Assessment Of Left Ventricular Remodeling And Left Ventricular Global Function In Patients With Coronary Heart Disease

Objective1. To evaluate left ventricular remodeling in patients with coronary heart disease by Real-time three-dimensional echocardiography,and to explore the correlation between left ventricle remodeling and severity of coronary artery stenosis.2.To observe the correlation between global three dimensional strain and left ventricular ejection fraction in patients with coronary heart disease.Methods1.Subjects:32 patients with clinical diagnosis of coronary heart disease and without ventricular segmental wall motion abnormality by two-dimensional echocardiography as lesion group,according to Gensini score,the lesion group were divided into mild lesion group(<50 points) and severe lesion group(?50 points), 27 healthy volunteers as control group.2.Equipments:Using GE Vivid E9 Demision ultrasound system with 4V ultrasonic probe of 1.7~3.3MHz and Echo PAC work station.3.Measurement:All the subjects underwent conventional echocardiograph,then Real-time three-dimensional echocardiography was used to measure its left ventricular end-diastolic volume(LVEDV), left ventricular end systolic volume(LVESV), left ventricular ejection fraction(LVEF), left ventricular myocardial quality(LVM),left ventricular remodeling index(LVRI,LVRI=LVM/LVEDV) respectively.The difference among the guoups were analyzed,and correlation analysis was performed between the left ventricular remodeling parameters and Gensini score in lesion gruop.All the subjects were also calculated the global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS) and global area strain(GAS) by using three dimensional speckle tracking imaging.then the differences of global three dimensional strain were compared among the groups,and correlation analysis was performed between the global three dimensional strain parameters and LVEF in lesion gruop.Results1.Compared the ecah group of gender, age, body mass index,there were no significant differences(P>0.05).2.Compared with the control group, the LVEDV, LVESV and LVM in lesion groups were all larger than the control group(P<0.05), LVEF,LVRI were both less than the control group(P<0.05). Compared with mild lesion group, the LVEDV and LVESV in severe lesion group were both larger than mild lesion group(P<0.05), LVEF and LVRI were both less than the mild lesion group(P<0.05),LVM was no significant difference(P>0.05).3.The LVEDV and LVESV in lesion gruop were positively correlated to Gensini score(r=0.54,P<0.05;r=0.71,P<0.05),the LVEF and LVRI were negatively correlated to Gensini score(r=-0.52,P<0.05;r=-0.47,P<0.05), LVM and the Gensini score were no significant correlation.4.Compared with the control group, the GLS in lesion gruops were less than the control group(P<0.05),the GRS,GCS and GAS in severe group were all less than the control group(P<0.05),and there was no significant difference in the rest groups(P>0.05).5.The GLS,GRS,GCS and GAS in lesion gruop were all positively correlated to Gensini score(r=0.36,P<0.05;r=0.42,P<0.05;r=0.63,P<0.05;r=0.52,P<0.05).Conclusions1.RT-3DE could objectively reflect the degree of left ventricular remodeling in patients with coronary artery disesae,and also it could indirectly evaluate the severity of coronary artery disease,maybe it could be used as a clinical evaluation of the effective index.2.3D-STI could ecactly evaluate left ventricular global systolic function,it shows good repeatability.The declination in global three dimensional strain may reflect the extend of coronary artery stenosis in CHD patients.