| Objective: The left ventricular myocardial strain,global and segmental systolic function of patients with coronary heart disease before and after percutaneous coronary intervention were evaluated by two dimensional speckle tracking imaging combined with left ventricular opacification echocardiography.Methods: Thirty-five patients with coronary heart disease who received percutaneous coronary intervention in the department of cardiology of our hospital from March 2018 to October 2019 were selected as the case group.In the case group,echocardiography was performed three days before PCI,one week after PCI,and one month after PCI.Patients with coronary heart disease were divided into three days before PCI(group A),one week after PCI(group B),and one month after PCI(group C).Coronary angiography was performed in all cases,and single or multiple coronary artery lesions of over 75% stenosis were confirmed in all cases,and PCI intervention was successfully performed.According to the coronary angiography to determine the number of coronary artery lesions,22 cases of single-branch coronary artery lesions(12 cases in the single-branch left anterior descending branch lesion group,9 cases in the single-branch right coronary artery lesion group,1 case in the single-branch left cyclotron branch lesion group),13 cases in the multi-branch coronary artery lesions group.A total of 35 healthy patients who underwent physical examination in the outpatient department of our hospital from March 2018 to October 2019 were selected as the control group.Routine echocardiography and LVO was performed in both groups,and left ventricular end-diastolic volume,end-systolic volume and left ventricular ejection fraction were measured using the Simpson method.The longitudinal strain and circumferential strainof the global systolic period of the left ventricle and the longitudinal strain and circumferential strain of each myocardium of the left ventricle were obtained by the2D-STI.The endocardial score of each segment of left ventricular myocardium before and after LVO in the case group was calculated,and the improvement rate of endocardial imaging was calculated.The results obtained were statistically analyzed.Results: 1.There were no statistically significant differences in LVESV,LVEDV,GLS and GCS between the case group one week after PCI and three days before PCI(P>0.05).In the case group,LVEDV and LVESV decreased one month after PCI compared with three days before PCI and one week after PCI(P<0.05).In the case group,there was no significant difference between LVEF one week after PCI and three days before PCI(P>0.05).In the case group,LVEF,GLS and GCS increased one month after PCI compared with three days before PCI and one week after PCI(P < 0.05).2.In the single-branch left anterior descending branch lesion group,the peak systolic longitudinal strain of MA,AA,BAS,MAS,AAS one month after PCI was significant higher than that three days before PCI and one week after PCI(P<0.05),the peak systolic circumferential strain of BA,BAS,MAS one month after PCI was significant higher than that three days before PCI and one week after PCI(P<0.05).In the single-branch right coronary artery lesion group,the peak systolic longitudinal strain of BIS?MIS?BI?MI one month after PCI was increased compared with that three days before PCI(P< 0.05),the peak systolic longitudinal strain of BIS?MIS one month after PCI was increased compared with that one week after PCI(P < 0.05),the peak systolic circumferential strain of BIS?MIS?BI?MI one month after PCI was higher than that three days before and one week after PCI(P < 0.05).3.The LVEDV and LVESV of the case group three days before PCI were higher than that of the control group(P < 0.05).The LVEF,GLS and GCS in the three days before PCI were decreased in the case group than in the control group(P<0.05).4.Compared with control grape,the systolic peak longitudinal and circumferential strain in BA,MA,AA,BAS,MAS,AS,BIS,MIS,BI,MI,AI,BIL,MIL,AL,MAL,Apex were decreased in the case grape three days before PCI(P<0.05).5.The GLS and GCS in the case group three days before PCI were decreased compared with the control group(P<0.05).The receiver-operatingcharacteristic curve showed that the area under ROC curve of GLS was 0.941(P < 0.05).When GLS=-15.5% was used as the critical value for detecting CHD,the sensitivity was 94.3% and the specificity was 82.9%.The area under ROC curve of GCS was0.896(P < 0.05).When GCS=-23.5% was used as the critical value for detecting CHD,the sensitivity was 91.4% and the specificity was 74.3%.6.In the case group,there was a correlation between GLS and LVEF(r=-0.593,P < 0.05),and a correlation between GCS and LVEF(r=-0.572,P < 0.05).7.There was a statistically significant difference in the number of cardiac muscle segments in the scores of endocardial boundaries before and after LVO in the case group(P < 0.05),and the improvement rate of endocardial imaging was 91.2%.Conclusion:1.In patients with CHD,the LVEF,GLS,GCS,the systolic peak longitudinal strain and circumferential strain of each ischemic segment were all increased one month after PCI compared with the preoperative level.After PCI,the stenosis or occlusion of coronary arteries was opened,the ischemic myocardium after myocardial reperfusion treatment activity gradually restored,left ventricular global and local myocardial systolic function gradually improved.2.LVO can clearly show the endocardium boundary,2D-STI can be used to measure the strain value of each myocardium segment of the left ventricle.According to the distribution of systolic peak longitudinal strain and circumferential strain descending segment of each segment of the myocardium,the diseased coronary artery of patients with coronary heart disease can be inferred indirectly.3.As a new method,2D-STI combined with LVO can accurately evaluate the left ventricular myocardial strain and the global and segmental systolic function of patients with coronary heart disease before and after PCI,which has broad clinical application value. |
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