Liu Fang, Lin Qing, Ding Lei, Sun Yan-shu, Fan Yan, Liu Qian-zhu, Liu Mei-lin
Department of Geriatric, First Hospital of Peking University, Beijing 100034, China.
Department of Geriatric, First Hospital of Peking University, Beijing 100034, China. Email:
Zhonghua Xin Xue Guan Bing Za Zhi. 2013 Oct;41(10):850-6.
To assess left ventricular (LV) strain by 3-dimensional speckle tracking imaging (3D-STI) in patients with coronary heart disease (CHD).
All subjects underwent invasive coronary angiography.2-dimensional and 3-dimensional echocardiography were performed in 52 subjects with suspected CHD. Longitudinal strain (LS) , circumferential strain (CS) , radial strain (RS) and area strain (AS) in 17 LV segments were acquired by 3D-STI respectively.
According to coronary angiography results, 35 (76.1%)subjects were diagnosed as CHD, and 138 coronary branches were divided into the control group(25 branches, 18.1%), the mild stenosis group (31 branches, 22.5%), the moderate stenosis group (43 branches, 31.2%) and the severe stenosis group (39 branches, 28.2%).3D-STI was performed with reliable tracking quality in 46(88.5%) out of the 52 subjects initially enrolled in this study. 3D-STI showed:(1)LS was similar between mild stenosis group and the control group (P > 0.05) and significantly reduced in the moderate stenosis group compared with the control group(P < 0.05), and LS in some segments (MAS, AA, A, BAL, MAL, AL, BIS, MIS and AI) of moderate stenosis group were significantly decreased compared with the mild stenosis group (P < 0.05). LS of all segments in the severe stenosis group decreased significantly compared with the control group, the mild stenosis group and the moderate stenosis (P < 0.05). (2)RS was similar between mild stenosis group and the control group (P > 0.05) . RS in some segments (BAS,MA and BI) was significantly decreased in the moderate stenosis group compared with the control group(P < 0.05). RS was significantly decreased in the severe stenosis group compared with the control group and the mild stenosis group (except for AS,AL,MIS,MI and AI) (P < 0.05). (3) CS was similar between mild stenosis group and the control group (P > 0.05) and was significantly reduced in some segments (BAS,AS,BIL and BI) of the moderate stenosis group compared with the control group(P < 0.05). CS was significantly decreased in the severe stenosis group compared with the control group, the mild stenosis group and the moderate stenosis(P < 0.05). (4) AS was significantly decreased in the mild stenosis group compared with the control group(P < 0.05, except for BIL,MAL and BIS) and in all segments of the moderate stenosis group compared with the control group and the mild stenosis group(P < 0.05). AS was significantly decreased in the severe stenosis group compared with the control group, the mild stenosis group and the moderate stenosis(P < 0.05). The progressive decrease in AS was observed from the control group to the mild stenosis group, the moderate stenosis group and the severe stenosis group (P < 0.05). In addition, AS was negatively correlated with coronary artery Gensini score (r = -0.71, P < 0.01) .
LV strain can be reliably quantified by 3D-STI. AS is a more sensitive parameter to detect coronary artery disease at early phase.
采用三维斑点追踪成像（3D-STI）评估冠心病（CHD）患者的左心室（LV）应变。
所有受试者均接受有创冠状动脉造影。对52例疑似冠心病患者进行二维和三维超声心动图检查。通过3D-STI分别获取17个左心室节段的纵向应变（LS）、圆周应变（CS）、径向应变（RS）和面积应变（AS）。
根据冠状动脉造影结果，35例（76.1%）受试者被诊断为冠心病，138支冠状动脉分支被分为对照组（25支，18.1%）、轻度狭窄组（31支，22.5%）、中度狭窄组（43支，31.2%）和重度狭窄组（39支，28.2%）。在本研究最初纳入的52例受试者中，46例（88.5%）进行了追踪质量可靠的3D-STI检查。3D-STI显示：（1）轻度狭窄组与对照组的LS相似（P>0.05），中度狭窄组与对照组相比LS显著降低（P<0.05），中度狭窄组某些节段（MAS、AA、A、BAL、MAL、AL、BIS、MIS和AI）的LS与轻度狭窄组相比显著降低（P<0.05）。重度狭窄组所有节段的LS与对照组、轻度狭窄组和中度狭窄组相比均显著降低（P<0.05）。（2）轻度狭窄组与对照组的RS相似（P>0.05）。中度狭窄组某些节段（BAS、MA和BI）的RS与对照组相比显著降低（P<0.05）。重度狭窄组与对照组和轻度狭窄组相比RS显著降低（AS、AL、MIS、MI和AI除外）（P<0.05）。（3）轻度狭窄组与对照组的CS相似（P>0.05），中度狭窄组某些节段（BAS、AS、BIL和BI）与对照组相比CS显著降低（P<0.05）。重度狭窄组与对照组、轻度狭窄组和中度狭窄组相比CS显著降低（P<0.05）。（4）轻度狭窄组与对照组相比AS显著降低（BIL、MAL和BIS除外，P<0.05），中度狭窄组所有节段与对照组和轻度狭窄组相比AS显著降低（P<0.05）。重度狭窄组与对照组,轻度狭窄组和中度狭窄组相比AS显著降低（P<0.05）。从对照组到轻度狭窄组、中度狭窄组和重度狭窄组观察到AS逐渐降低（P<0.05）。此外，AS与冠状动脉Gensini评分呈负相关（r=-0.71，P<0.01）。
3D-STI可可靠地量化左心室应变。AS是早期检测冠状动脉疾病的更敏感参数。
