Correlation Research Between Coronary Artery Lesions And Real-time Three-dimensional Echocardiographic Parameters

Object:In this study,we used real-time three-dimensional echocardiography to measure left ventricular systolic,diastolic function and synchronization parameters,aiming to observe the correlation between the parameters and the degree of coronary artery stenosis,so as to provide early,noninvasive detection method.Methods:50 cases patients with coronary heart disease were selected in our hospital from 2015.11 to 2016.11.All patients were selected according to the inclusion criteria and given coronary angiography.All kinds of heart diseases such as arrhythmia,congenital heart disease,heart failure and stent implantation were excluded.According to the Gensini score,patients were divided into group B Gensini score 31-60 points,group C Gensini score> 60 points,each group of 25 patients.Another 25 patients with suspected coronary arteriosclerotic heart disease were enrolled in this study as control group(group A).But after coronary angiography confirmed coronary artery normal and exclude cardiac organic disease.This study used Philips iE-33 color Doppler ultrasound diagnostic apparatus,equipped with X3-1 matrix real-time phased array three-dimensional probe(frequency 1-3MHz),and two-dimensional phased array S5-1 probe(frequency I-5MHz).Using the Philips i E-33 Qlab(Quantitation laboratory)quantitative analysis software to describe the dynamic three-dimensional endocardial "thin shell-like" stereoscopic image and time-displacement parameter map,left ventricular global(Global)and section(Regional)volume-time curve(Volumetimecurves,VTC)changes in the trend,and calculated the following related parameters:(1)Cardiac function parameters:(1)left ventricular end-systolic volume(ESV),left ventricular total diastolic volume(EDV),and left ventricular ejection fraction(LVEF).(2)Left ventricular peak ejection rate(PER)=(LVEDV-LVESV)/ t,1/3 filling fraction(1/3FF)= [(V-LVESV)/(LVEDV-LVESV)] × 100%(t refers to diastolic time,V is the volume of the1/3 filling time point),and the peak filing rate(PFR).(2)Synchronization parameters: the standard deviation of the minimum systolic volume of the left ventricle 16 segments(16Tmsv16-sd),The maximum difference of the left ventricular 16 segment to the minimum end-of-volume volume time(Tmsv16-dif).In order to eliminate the influence of statistical data on the difference of heart rate between different groups and to improve the comparability of each group of data,the above data were corrected,divided by the electrocardiogram RR interval of the subjects,respectively,to obtain the corrected percentage: Tmsv16-dif%,Tmsv16-sd%.In this study,the above parameters were analyzed and compared.Statistical methods: Statistical analysis software SPSSl6.0 version of the analysis and processing software for data processing and analysis.Metrological data were expressed as mean ± standard deviation(x ± S),count data expressed as a percentage(%),the rate of comparison using X2 test.General clinical data between groups were compared using two independent samples f-test.Multiple-group comparisons were performed using one-way ANOVA.For the non-normal distribution data,the two groups were used to compare the two independent samples using the rank sum test(U test);the correlation between the two groups of data analysis,consistent with the normal distribution by Pearson analysis,does not meet the normal distribution Using the Spearman method.Correlation test between two data using linear correlation analysis method.The predictive value of multi-segment non-synchronous parameters for coronary stenosis was evaluated using the receiver operator curve(ROC),and the area under curve(AUC)was calculated and tested.P<0.05 for the difference was significant,P<0.01 for the difference was statistically significant.Results:1 Gender,age,heart rate,blood pressure,body mass index,blood glucose and blood lipids in group A,group B and group C had no significantdifferences(P>0.05).2 Compared with group A,the differences of Tmsv16-sd,Tmsv16-dif,Tmsv16-sd%(SDI)and Tmsv16-dif% were significant in group B,and LVEF,LVEDV,LVESV,Tmsv16-sd,Tmsv16-dif,Tmsv16(SDI),Tmsv16-dif% and DISPES16 in group C were significantly different(P<0.05);Compared with group B,there were significant differences in LVEF,LVEDV,LVESV,Tmsv16-sd,Tmsv16-dif,Tmsv16-sd%(SDI),Tmsv16-dif% and DISPES16 in group C(P<0.05).The severity of coronary artery disease was associated with the following factors: LVEF,LVEDV,LVESV,Tmsv16-sd,Tmsv16-dif,Tmsv16-sd%(SDI),Tmsv16-dif%,DISPES16.3 Compared with group A,the scores of e',E / e',PFR,1 / 3FF,DDI in group B were significantly different(P<0.05 or P<0.01),and e',E / e',PFR,/3FF,DDI and DISPED were significantly different in group C(P<0.05 or P<0.01).Compared with group B,there were significant differences in the DISPED index in group C(P<0.05).The above indicates that the degree of coronary artery disease is related to the following factors: e',E / e',PFR,1 /3FF,DDI,DISPED.4 In different Gensini scores,there was a significant negative correlation between the degree of coronary artery stenosis and LVEF,e',PFR,1 / 3FF(r=-0.758,-0.586,-0.629,-0.714;P<0.01).The degree of coronary artery stenosis was positively correlated with Tmsv16-sd,Tmsv16-dif,Tmsv16-sd%,Tmsv16-dif%,DISPES,E / e',DDI,DISPED(r=0.683,0.632,0.716,0.618,0.654,0.597,0.596;P<0.01).5 Bull eyes and control group A showed that the segments showed almost uniform solid color,suggesting that left ventricular systolic,diastolic function and good synchronization.B,C showed myocardial contraction in the ischemic area and adjacent segments were delayed(local red),no obvious ischemic regional contraction of the regional synchronization is better(mostly green or blue),segment parameters show shrinkage delay Degree and coronary stenosis degree was basically the same relationship.Conclusions:1 There was a significant correlation between the degree of coronary artery stenosis and the RT-3DE parameters in different Gensini scores.2 In different Gensini scores,there was a significant negative correlation between the degree of coronary artery stenosis and LVEF,e',PFR,1 / 3FF(r=-0.758,-0.586,-0.629,-0.714;P<0.01).The degree of coronary artery stenosis was positively correlated with Tmsv16-sd,Tmsv16-dif,Tmsv16-sd%,Tmsv16-dif%,DISPES,E / e',DDI,DISPED(r=0.683,0.632,0.716,0.618,0.654,0.597,0.596;P<0.01).3 The above parameters can be used to reverse the possibility of coronary heart disease through the RT-3DE,has a certain predictive value on the degree of coronary heart disease for the clinical judgment of suspicious patients,and provide a preliminary screening basis for the clinical judgment of suspicious patients on coronary angiography.4 SDI16 and DDI16 can quantitatively evaluate the left ventricular systolic and diastolic dyssynchrony parameters of coronary heart disease,which can reflect left ventricular systolic and diastolic dyssynchrony.It also has a good clinical value on quantitative evaluation of left ventricular dyssynchrony in patients with coronary heart disease.5 Left ventricular time-displacement parameters and volume-time curve,shows the ventricular volume,wall motion and dynamic changes in function,from the overall and segmental perspective,can evaluate the coronary artery stenosis after the left ventricular mechanical contraction synchronized state changes intuitively and timely,can be used as a supplementary method to evaluate the evaluation of left ventricular function after varying degrees of coronary artery stenosis.