Evaluation of segmental myocardial function in patients with chronic coronary syndrome by adenosine stress echocardiography combined with myocardial work
Objective To evaluate the changes of segmental myocardial function in patients with chronic coronary syndrome(CCS)before and after adenosine stress by applying adenosine stress echocardiography(ASE)combined with myocardial work(MW)parameters.Methods A total of 43 patients with CCS admitted to Yan'an Hospital Affiliated to Kunming Medical University from January 2022 to January 2023 were selected and all examined by coronary angiography after applying ASE.The left ventricular 18-segment model was used to exclude 27 segments with unsatisfactory images,and 747 myocardial segments obtained were divided into the normal control group(stenosis=0),the mild stenosis group(stenosis ≤ 50％),the moderate stenosis group(50％＜stenosis ≤ 75％),and the severe stenosis group(75％＜stenosis)according to the results of coronary angiography.Before and after adenosine stress,the change rules in longitudinal strain of segmental myocardium and MW parameters were evaluated.Results With the increase of coronary artery stenosis,the left ventricular systolic function of patients with CCS would be damaged to varying degrees,and the MW level would decrease.The MW parameters changed obviously before and after adenosine stress,when coronary artery stenosis was mild or moderate,the vasodilation effect of adenosine improved coronary blood flow perfusion and the MW level increased after stress;However,in severe stenosis,the coronary blood flow of stenosis that lost its reserve function was significantly reduced,which significantly reduced the MW level after stress.The diagnostic value of stress myocardial useful work was the highest in predicting the occurrence of severe coronary stenosis,which was superior to other work parameters.Conclusion Application of ASE combined with MW parameters can quantitatively evaluate the segmental myocardial function of patients with CCS,and predict the left ventricular function of patients by comparing the differences of segmental myocardium under basic and stress conditions,which will provide help in clinical diagnosis and treatment.
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