Evaluation of regional left ventricular myocardial function in patients with anterior descending lesion by real-time three-dimensional speckle tracking imaging / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the systolic and diastolic function of the left ventricular regional myocardium in patients with anterior descending lesion by real-time three-dimensional speckle tracking imaging (RT3D-STI) and investigate the value of RT 3D-STI in the diagnosis of anterior descending stenosis.Methods According to coronary angiography,112 patients were divided into four groupsnormal group (20 coronary artery branches without stenosis),mild stenosis group ( 30 coronary artery branches with stenosis<50% ),moderate stenosis group(26 coronary artery branches with stenosis 50% -75% ) and sever stenosis group (36 coronary artery branches with stenosis > 75% ). Transthoracic acquisition of conventional 2D and full-volume real-time three-dimensional image,the routine parameters and the globle longitudinal strain (GLS),globle radial strain (GRS),globle circumferential strain (GCS) and globle area strain (GAS) at the end of the anterior descending blood supply area and corresponding strain of 1/3 of pre-diastolic period were obtained to calcute L-SI-DI,R-SI-DI,C-SI-DI,and A-SI-DI. The diagnostic value of each parameter to the stenosis degree of the anterior descending branch was analyzed. Results Compared among the anterior descending group without stenosis group,mild stenosis group,moderate stenosis group and severe stenosis group,there were no significant differences in conventional ultrasonic parameters such as LVEDV,LVESV,LVEF,E,A,E/A and E/e (all P >0.05).There was no significant difference in GLS, GRS,GCS and GAS between mild stenosis group and no stenosis group(all P >0.05),but the difference in L-SI-DI,R-SI-DI,C-SI-DI and A-SI-DI were statistically significant (all P <0.05).The ROC curve showed that the sensitivity and specificity of the middle anterior segment L-SI-DI were the highest,with 90.0% and 81.5%.Conclusions RT3D-STI can quantitative evaluate myocardial function changes in patients with anterior descending lesion,the anterior septal L-SI-DI can reflect the stenosis degree of the anterior descending branch to a certain extent,it has important guiding significance for clinical diagnosis of the stenosis degree of the anterior descending branch.