Clinical value of two-dimensional speckle tracking imaging in evaluating myocardial mechanical changes after percutaneous coronary intervention in patients with coronary heart disease combined with severe stenosis of left anterior descending artery
Objective To explore the clinical value of two-dimensional speckle tracking imaging(2D-STI)in evaluating the mechanical changes of myocardium before and after percutaneous coronary intervention(PCI)in coronary heart disease(CHD)patients with severe stenosis of left anterior descending artery(LAD).Methods Thirty-three patients with severe stenosis of LAD who underwent elective PCI and met the criteria for stent implantation at Suining Central Hospital from January 2020 to May 2021 were selected as the observation group.Routine echocardiography and 2D-STI examinations were performed before surgery,3-5 days after surgery,and 1 month and 3 months after surgery.Thirty-five patients with no significant stenosis confirmed by coronary angiography during the same period were selected as the control group.Routine cardiac parameters including left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),and left ventricular ejection fraction(LVEF)were measured.The left ventricle was divided into 17 segments.Strain analysis was performed using aCMQ software to obtain left ventricular global longitudinal strain(GLS),global circumferential strain(GCS),and longitudinal and circumferential strain of 6 segments supplied by LAD including basal anterior(BA),mid anterior(MA),apical anterior(AA),basal anteroseptal(BAS),mid anteroseptal(MAS)and apical septal(AS).Statistical comparative analysis was performed on the above parameters.Results Compared with the control group,LVEF,absolute values of GLS and GCS,longitudinal and circumferential strains of BA,MA,AA,BAS,MAS and AS decreased in the observation group before PCI(P<0.05).There were no significant changes in these parameters between 3-5 days after surgery and before surgery in the observation group,the differences were not statistically significant(P>0.05).The above parameters at 3 months after surgery were higher than those at 1 month after surgery,but still lower than those in the control group(P<0.01)except for LVEF.There was a positive correlation between LVEF and the mean absolute values of longitudinal and circumferential strain of 6 segments at each time point after PCI(r=0.482,0.474;P<0.01).Conclusion 2D-STI can sensitively and accurately evaluate changes in local and global myocardial systolic dynamics of left ventricle in CHD patients with severe stenosis of LAD after PCI.
万方数据
维普
