Cai Zekun, Dai Jianwei, Wu Dan, Qiu Jian, Ma Jun, Li Guoying, Zhu Wei, Lei Hongqiang, Huang Wenhua, Zhang Heye, Xu Lin
aDepartment of Cardiology, Guangzhou General Hospital of Guangzhou Military Region, PLA, Guangzhou bThe Second Affiliated Hospital of Shantou University Medical College, Shantou cInstitute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Shenzhen dDepartment of Ultrasound, Guangzhou General Hospital of Guangzhou Military Region, PLA eSouthern Medical University, Guangzhou, China.
Medicine (Baltimore). 2016 Sep;95(39):e4667. doi: 10.1097/MD.0000000000004667.
The aim of this study is to investigate the value of 3-dimensional global peak longitudinal strain (GPLS) derived from the 3-dimensional speckle-tracking echocardiography (3D-STE) in the diagnosis of the complex non-ST-segment elevation acute coronary syndromes (NSTE-ACS) by comparing GPLS to the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score.A total of 59 inpatients with NSTE-ACS in our hospital between October 2014 and January 2015 were enrolled into our study. All these subjects underwent the coronary angiography (CAG) and 3D-STE examination. The results of CAG were used to calculate the SYNTAX scores in each subject. The GPLS was assessed with speckle-tracking analysis using the dedicated software developed by GE Healthcare (Horten, Norway).We grouped all subjects according to the SYNTAX scores. A total of 23 patients (39%) were grouped as complex NSTE-ACS in our experiment. In our analysis, the values of GPLS significantly decreased from low SYNTAX scores to intermediate or high SYNTAX scores (-14.0 ± 2.7% and -9.5 ± 2.8%, respectively, P < 0.001). Multivariate regression analysis showed that GPLS and diabetes mellitus were independent predictors for complex NSTE-ACS. The area under the receiver operator characteristic curve (AUC) for GPLS to evaluate patients with complex NSTE-ACS was 0.882 (95% confidence interval [CI], 0.797-0.967, P < 0.001) with an optimal cutoff value of -11.76% (sensitivity 82.6% and specificity 83.3%). The evaluative value of the adjusted AUC for evaluating patients with complex NSTE-ACS improved after inclusion of GPLS (C statistics, 0.827-0.948, P < 0.001).The value of GPLS is significantly associated with the complexity of coronary artery lesions, according to SYNTAX score. Therefore, our study indicates that GPLS could be reproducible and efficient to evaluate the complex coronary artery disease in NSTE-ACS patients.
本研究旨在通过比较三维斑点追踪超声心动图（3D-STE）得出的三维整体峰值纵向应变（GPLS）与经皮冠状动脉介入治疗紫杉醇与心脏手术协同作用（SYNTAX）评分，探讨其在诊断复杂非ST段抬高型急性冠状动脉综合征（NSTE-ACS）中的价值。2014年10月至2015年1月期间，我院共纳入59例NSTE-ACS住院患者。所有这些受试者均接受了冠状动脉造影（CAG）和3D-STE检查。CAG结果用于计算每个受试者的SYNTAX评分。使用通用电气医疗集团（挪威霍滕）开发的专用软件通过斑点追踪分析评估GPLS。我们根据SYNTAX评分对所有受试者进行分组。在我们的实验中，共有23例患者（39%）被归类为复杂NSTE-ACS。在我们的分析中，GPLS值从低SYNTAX评分到中或高SYNTAX评分显著降低（分别为-14.0±2.7%和-9.5±2.8%，P<0.001）。多因素回归分析表明，GPLS和糖尿病是复杂NSTE-ACS的独立预测因素。GPLS评估复杂NSTE-ACS患者的受试者操作特征曲线（AUC）下面积为0.882（95%置信区间[CI]，0.797-0.967，P<0.001），最佳截断值为-11.76%（敏感性82.6%，特异性83.3%）。纳入GPLS后，评估复杂NSTE-ACS患者的校正AUC评估价值有所提高（C统计量，0.827-0.948，P<0.001）。根据SYNTAX评分，GPLS值与冠状动脉病变的复杂性显著相关。因此，我们的研究表明，GPLS在评估NSTE-ACS患者的复杂冠状动脉疾病方面具有可重复性和高效性。
