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Objective To evaluate the role of treadmill exercise‐stress echocardiography in the assessment of left ventricular ( LV ) function in patients with slow coronary flow ( SCF ) ,and discuss the possible mechanism of SCF . Methods Forty‐six patients with diagnosis of SCF were enrolled as SCF group . Forty age and sex matched adults were included as control group . All subjects had underwent clinical evaluation and exercise stress echocardiography . LV diastolic and systolic functions were assessed by conventional echocardiography , tissue Doppler imaging and two‐dimensional speckle tracking echocardiography at rest and during exercise . Results ①LV function in patients with SCF at rest :LV peak systolic longitudinal strain ( LS) was lower in patients with SCF than that in controls ( P ＜0 .05) . T here was no difference of LV ejection fraction ( LVEF) between the two group( P＞0 .05) . Early diastolic mitral annulus velocity ( M itral e′) and the ratio between the early mitral inflow velocity and Mitral e′( M itral E/e′) were significantly decreased in SCF group( all P＜0 .01 ) . ②LV function during exercise :LVEF ,LS and M itral e′were significant increased in two groups ( all P ＜0 .05 ) than those at rest ,but there was no significant difference of LVEF ,LS ,M itral e′ and M itral E/e′ between the two groups ( all P ＞ 0 .05 ) . Compared with control group ,ΔLS and ΔM itral e′were significantly higher in SCF group ( all P＜0 .05 ) . Conclusions LV systolic and diastolic function in patients with SCF are impaired at rest . LV systolic and diastolic function recover in patients with SCF during exercise .
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Objective To evaluate the effect of septal flash (SF) on left ventricular function and systolic synchrony in patients with complete left bundle branch block (CLBBB) and preserved left ventricular ejection fraction (LVEF) by two-dimensional speckle-tracking imaging (2D-STI).Methods Sixty CLBBB patients with preserved LVEF were selected,and 30 healthy individuals serving as control group.The SF of CLBBB patients were evaluated using 2D-STI,and the CLBBB patients were categorized into two groups (SF group and NSF group) based on the present SF.Conventional echocadiography and 2D-STI were performed for all individuals.Results ①SF was present in 53.3％ of CLBBB patients with preserved LVEF and was not present in control group.②LV longitudinal peak stain of global (LS-G) in SF group was lower than those in both control group and NSF group (P ＜0.05),and there was no significant difference between control group and NSF group (P ＞0.05).③Compared with control group,there were significant increase of left atrial dimension and Mitral E/e'and decrease in mitral E/A and mitral e'in SF group and NSF group (P ＜0.05),while there was no significant difference between SF group and NSF group (P ＞0.05).④There was an increase in standard deviation of time to peak systolic strain for the 18 LV segments (LV-SDt) in SF group and NSF group,and the LV-SDt in SF group was higher than that in NSF group (P ＜0.01).Conclusions SF is present in 53.3 ％ of CLBBB patients,patients of CLBBB with SF have lower left ventricular systolic function and systolic synchrony.
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Objective To evaluate left ventricular systolic and diastolic functions of patients with coronary slow flow (CSF) according to left ventricular myocardial systolic/diastolic performances (MSP/MDP) by using two-dimensional speckle tracking echocardiography (STE).Methods Fifty patients with CSF diagnosed with coronary angiography (CSF group) and 45 patients without CSF (control group) underwent STE.Left ventricular systolic longitudinal,radial and circumferential peak strain and early-diastolic peak strain rate were measured,and left ventricular MSP and MDP were calculated,then the results were statistically analyzed between the 2 groups.Results Compared with control group,left ventricular systolic longitudinal,radial and circumferential peak strain and early-diastolic peak strain rate,MSP and MDP reduced in CSF group (all P＜0.05).The mean thrombolysis in myocardial infarction (TIMI) frame count (TFC) of coronary artery was negatively correlated with MDP (r=-0.23,P=0.04),and the number of affected coronary arteries was negatively correlated with MDP (r=-0.31,P=0.03).There was significant difference of MDP among patients with different numbers of affected coronary arteries and control group (all P＜0.05),and MDP in affected 2 and 3 coronary arteries patients were lower than those of the control group (all P＜ 0.05).Conclusion Left ventricular systolic and diastolic functions is impaired in patients with CSF.The mean TFC and the number of affected coronary arteries are negatively correlated with left ventricular diastolic function.Left ventricular MSP and MDP are comprehensive parameters in evaluating systolic and diastolic functions.
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Objective To evaluate the value of two-dimensional speckle tracking echocardiography (2D-STE) in assessing left ventricular systolic function,diastolic function and synchrony with different QRS complex duration in complete left bundle branch block (CLBBB) patients with preserved left ventricle ejection fraction (LVEF).Methods A total of 44 patients with CLBBB and LVEF≥50％ were included.All the patients were divided into two groups based on QRS duration,QRS＞150 ms as wide QRS group and 120 ms≤QRS≤150 ms as narrow QRS group.And 30 healthy people were included as control group.Two-dimensional echocardiography and 2D-STE were performed.Ieft ventricle longitudinal peak stain of global,septum and free wall (LS-G,LS-Sept,LS-Lat),standard deviation of time to peak systolic strain for the 18 left ventricular segments (SDt) and index of left yen tricular diastolic function (EDT,E/A and E/e') were measured.Results SDt values of wide QRS group and narrow QRS group were significantly higher than that of control group (both P＜0.01).And SDt of wide QRS group was significantly higher than that of narrow QRS group (P＜0.05).LVEF and LS-G in wide QRS group were significantly lower than those in both narrow QRS group and control group (all P＜ 0.05),while there was no significant difference between narrow QRS group and control group (all P＞0.05).The LS-Sept in wide QRS group and narrow QRS group were both lower than that of control group (both P ＜0.01).And LS-Sept in wide QRS group was lower than that of narrow QRS group (P＜0.01).LS-Lat in narrow QRS group was separately higher than those of both wide QRS group and control group (both P＜0.05),while there was no significant difference of LS-Lat between wide QRS group and control group (P＞0.05).Compared with control group,E/A and EDT decreased and of E/e' increased in both wide QRS group and narrow QRS group (all P＜0.05).While there was no significant difference between wide QRS group and narrow QRS group (all P＞0.05).Conclusion In patients of wide QRS CLBBB with preserved LVEF,left ventricular systolic,diastolic function and synchrony decrease,while left ventricular systolic function of patients with narrow QRS do not significantly decrease.