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Objective To explore the value of real‐time three‐dimensional speckle tracking imaging (RT‐3D‐STI) in the early detection of globle and regional left ventricular myocardial systolic function in patients of coronary stenosis without regional wall motion abnormality. Methods 64 coronary stenosis patients without regional wall motion abnormality were divided into 2 groups according to angiography (CAG):without coronary stenosis group( n = 20) and coronary stenosis group ( n = 44), and all the myocardial segments of the patients were divided into 5 groups:without coronary stenosis group normal myocardial segments ( n = 340 ), coronary stenosis group normal myocardial segments ( n = 235 ), mild coronary stenosis myocardial segments( n = 126), moderate coronary stenosis myocardial segments( n =213) and severe coronary stenosis myocardial segments( n =174). Real‐time three‐dimensional full volume of left ventricle was obtained, left ventricular global area strain (GAS)and regional area strain(AS) of 17 myocardial segments, etc, were measured by RT‐3D‐STI respectively. The parameters between the two groups and among the five sub groups were compared, the correlation between GAS and coronary artery Gensini score was also analyzed. Results GAS in coronary stenosis group significantly reduced compared with without coronary stenosis group( P 0 0.5) S.egmental AS in moderate and severe coronary stenosis myocardial segments significantly reduced ( P < 0.05 ), and that in severe coronary stenosis myocardial segments was lower than that in moderate coronary stenosis myocardial segments, the differences were statistically significant ( P < 0.05 ). In addition, GAS was significantly correlated with coronary artery Gensini score( r =0.828, P <0.01). Conclusions RT‐3D‐STI can quantitatively assess the early changes of left ventricular globle and regional myocardial systolic function in patients with coronary stenosis.
ABSTRACT
ObjectiveTo evaluate the accuracy of measurement of left ventricular(LV) volume and function in coronary heart disease(CHD) by real-time three-dimensional echocardiography(RT-3DE) using cardiac magnetic resonance imaging (CMRI).Methods LV end diastolic volume(EDV),LV end systolic volume(ESV) and LV ejection fraction(EF) were measured with RT-3DE in patients with CHD ( n =37) and in the control ( n =30).The results measured by RT 3DE were compared with those of CMRI.The diagnostic value of RT-3DE was evaluated using receiver operating characteristic(ROC) curve.Results Compared with that measured by CMRI,EDV,ESV and EF by RT 3DE( P ＞0.05) were almost similar as that in the control.Area under ROC curve of in EDV and ESV were 0.912 and 0.944 in the control.However,EDV determined by RT-3DE was smaller than that by CMRI( P ＜0.05) in CHD group.A difference (10.95 ± 31.26 ml) was existed in EDV between the two methods.ESV measured by RT-3DE was smaller than that calculated by CMRI( P ＞0.05) with a mean differance of (3.17 ± 16.42)ml in CHD group.EF by RT-3DE( P ＞0.05)was almost as same as that by CMRI in CHD group,with a mean difference of (1.54 ± 11.85)％.The area under ROC curve of EDV and ESV were 0.834 and 0.873 in CHD group and their diagnostic performance was moderate.ConclusionsMeasurment of LV volume and function by RT 3DE in control was more acurrate than that in CHD.In the cases of LV remodeling in patients with CHD,RT-3DE would underestimate the LV volume.
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Objective To assess the effects of QRS duration on left ventricular systolic synchronicity in patients with heart failure by real-time three-dimensional echocardiography(RT-3DE).Methods Thirty-four patients with heart failure(LVEF≤35%)were selected and divided into two groups.Group A consisted of 20 patients with normal QRS duration,and group B included 14 patients with long ORS duration.All the patients underwent two-dimensional echocardiography(2DE)and RT-3DE respectively.Parameters including left ventricular inlernal diameter(LVIDd),left ventricular ejection fraction(LVEF)of 2DE,and left ventricular endsystolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),LVEF,the time to minimal systolic volume of 16-segmental standard deviation as a ratio of R-R interval(Tmsv16-sd/RR)of RT-3DE were obtained and analyzed between the two groups.Results There were no significant differences of LVIDd,LVEF acquired by 2DE between the two groups(P＞0.05);LVESV,LVEDV,Tmsv16-sd/RR of RT-3DE were slightly higher in group B than those in group A,but didn't reach the significant difference between the two groups(P＞0.05).The mechanical dyssynchrony maybe related to the severity of heart failure.Conclusions RT-3DE can quantify global left ventricular systolic synchronicity.QRS duration has no significant effect on left ventricular systolic synchronicity in patients with heart failure.