ABSTRACT
<p><b>OBJECTIVE</b>To assess left ventricular (LV) strain by 3-dimensional speckle tracking imaging (3D-STI) in patients with coronary heart disease (CHD).</p><p><b>METHODS</b>All subjects underwent invasive coronary angiography.2-dimensional and 3-dimensional echocardiography were performed in 52 subjects with suspected CHD. Longitudinal strain (LS) , circumferential strain (CS) , radial strain (RS) and area strain (AS) in 17 LV segments were acquired by 3D-STI respectively.</p><p><b>RESULTS</b>According to coronary angiography results, 35 (76.1%)subjects were diagnosed as CHD, and 138 coronary branches were divided into the control group(25 branches, 18.1%), the mild stenosis group (31 branches, 22.5%), the moderate stenosis group (43 branches, 31.2%) and the severe stenosis group (39 branches, 28.2%).3D-STI was performed with reliable tracking quality in 46(88.5%) out of the 52 subjects initially enrolled in this study. 3D-STI showed:(1)LS was similar between mild stenosis group and the control group (P > 0.05) and significantly reduced in the moderate stenosis group compared with the control group(P < 0.05), and LS in some segments (MAS, AA, A, BAL, MAL, AL, BIS, MIS and AI) of moderate stenosis group were significantly decreased compared with the mild stenosis group (P < 0.05). LS of all segments in the severe stenosis group decreased significantly compared with the control group, the mild stenosis group and the moderate stenosis (P < 0.05). (2)RS was similar between mild stenosis group and the control group (P > 0.05) . RS in some segments (BAS,MA and BI) was significantly decreased in the moderate stenosis group compared with the control group(P < 0.05). RS was significantly decreased in the severe stenosis group compared with the control group and the mild stenosis group (except for AS,AL,MIS,MI and AI) (P < 0.05). (3) CS was similar between mild stenosis group and the control group (P > 0.05) and was significantly reduced in some segments (BAS,AS,BIL and BI) of the moderate stenosis group compared with the control group(P < 0.05). CS was significantly decreased in the severe stenosis group compared with the control group, the mild stenosis group and the moderate stenosis(P < 0.05). (4) AS was significantly decreased in the mild stenosis group compared with the control group(P < 0.05, except for BIL,MAL and BIS) and in all segments of the moderate stenosis group compared with the control group and the mild stenosis group(P < 0.05). AS was significantly decreased in the severe stenosis group compared with the control group, the mild stenosis group and the moderate stenosis(P < 0.05). The progressive decrease in AS was observed from the control group to the mild stenosis group, the moderate stenosis group and the severe stenosis group (P < 0.05). In addition, AS was negatively correlated with coronary artery Gensini score (r = -0.71, P < 0.01) .</p><p><b>CONCLUSION</b>LV strain can be reliably quantified by 3D-STI. AS is a more sensitive parameter to detect coronary artery disease at early phase.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Coronary Artery Disease , Diagnostic Imaging , Echocardiography, Three-Dimensional , Methods , Heart Ventricles , Ventricular Function, LeftABSTRACT
<p><b>OBJECTIVE</b>To investigate the predictive value of the ambulatory blood pressure monitoring parameters on left ventricular hypertrophy (LVH) and carotid artery intima-media thickness (IMT) in the hypertensives.</p><p><b>METHODS</b>We evaluated 147 hypertensive patients who were never treated regularly before. All patients underwent ultrasound examinations of the heart and the IMT of carotid arteries. We classified them as LVH group (n = 45) or no LVH group (n = 102), and as IMT increased group (n = 52) or no IMT increased group (n = 95). The record of medical history, physical examination and 24 h ambulatory blood pressure monitoring (ABPM) were performed in all the patients. The biochemical parameters such as blood lipids, glucose and so on were tested. Then the data comparison was made.</p><p><b>RESULTS</b>(1) There were no significant differences in clinical manifestations and biochemical parameters between the LVH and no LVH groups (P > 0.05). Age (68.3 +/- 6.2) year vs (65.6 +/- 5.8) year, male 75.6% vs 66.7%, body mass index (24.1 +/- 4.1) vs (23.8 +/- 4.7) (kg/m(2)), diabetes mellitus and(or) impaired glucose tolerance 40.0% vs 38.2%, angina pectoris 42.3% vs 38.9%, cerebral vascular diseases 19.2% vs 15.7%, total cholesterol (5.40 +/- 1.42) vs (5.28 +/- 1.46) mmol/L, triglycerides (1.80 +/- 1.02) vs (1.74 +/- 1.08) mmol/L, low-density lipoprotein cholesterol (4.03 +/- 1.43) vs (4.06 +/- 1.48) mmol/L, high-density lipoprotein cholesterol (1.00 +/- 0.30) vs (0.99 +/- 0.26) mmol/L. (2) The parameters of ABPM in LVH group were higher than those in no LVH group. There were significant differences (P < 0.05) in 24 h mean systolic blood pressure (140.7 +/- 14.1) vs (128.3 +/- 12.3) mm Hg, 24 h mean diastolic blood pressure (86.4 +/- 8.9) vs (81.6 +/- 9.3) mm Hg, daytime mean systolic blood pressure (142.8 +/- 13.9) vs (130.9 +/- 11.1) mm Hg, daytime mean diastolic blood pressure (86.9 +/- 8.8) vs (83.4 +/- 9.0) mm Hg, nighttime mean systolic blood pressure (129.0 +/- 13.2) vs (114.6 +/- 11.4) mm Hg, nighttime mean diastolic blood pressure (77.2 +/- 9.4) vs (67.5 +/- 8.1) mm Hg, 24 h pulse pressure (54.2 +/- 10.2) vs (46.9 +/- 9.6) mm Hg, daytime pulse pressure (55.9 +/- 10.5) vs (47.5 +/- 9.1) mm Hg, nighttime pulse pressure (51.8 +/- 10.7) vs (47.1 +/- 8.7) mm Hg, 24 h systolic blood pressure variance (8.4 +/- 2.0) vs (7.2 +/- 1.9), 24 h diastolic blood pressure variance (9.5 +/- 2.2) vs (8.0 +/- 2.1), the non-dipper rhythm of ambulatory blood pressure 55.6% vs 25.5%. (3) There were also no significant differences in clinical manifestations between the IMT increased and no IMT increased group (P > 0.05). While there were significant differences between the IMT increased and no IMT increased group in those parameters of ABPM (P < 0.05).</p><p><b>CONCLUSION</b>There were more LVH or IMT increased persons in the hypertensives whose ABPM parameters were abnormal.</p>