Hertz Adi, Jerdev Michael, Grosman-Rimon Liza, Ben-Zakai Itiel, Rimon Jordan, Amir Offer, Greener Gabby Elbaz, Carasso Shemy
The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel.
Cardiovascular Institute, B Padeh Medical Center, Poriya, Israel.
Int J Cardiol Heart Vasc. 2024 Dec 28;56:101586. doi: 10.1016/j.ijcha.2024.101586. eCollection 2025 Feb.
Cardiac computerized tomographic angiography (CCTA) is perceived as a non-invasive tool for assessment of coronary vessel anatomy. Feature tracking echocardiography has recently emerged as a tool for assessment of regional and global left ventricular function. We aimed to explore the applicability of echocardiographic strain on CCTA cine clips and assess whether global and regional strain parameters are associated with the extent of coronary stenosis.
CCTA studies of 61 consecutive patients were reconstructed to yield cine images in classic echocardiographic long and short views. Siemens Velocity Vector Imaging (VVI) software was applied to generate strain and displacement results. Volumetric and mechanics parameters were compared among patients with no or non-significant coronary artery disease (CAD) and patients with significant CAD. Finally, a comparison of the degree of coronary stenosis to regional segmental strain was performed.
Myocardial mechanics parameters could be generated in 60 cases. Ejection fraction (EF) and left ventricular end diastolic volume (LVEDV) were within the normal range in both groups. VVI values were lower in the CAD group (VVI LVEF 59 ± 6 vs. 50 ± 11, p = 0.0002). Global longitudinal and global circumferential strain both were significantly lower in this group. Regional segmental strain was lower in segments affected by coronary stenosis in comparison to unaffected segments.
While CT segmentation derived LVEF did not differ among groups, patients with significant coronary stenosis had reduced longitudinal and circumferential contraction. This suggests that application of VVI to CCTA cine clips tracking may help to differentiate significant and non-significant coronary stenosis, adding functional value to anatomic findings in CCTA.
心脏计算机断层血管造影（CCTA）被视为评估冠状动脉解剖结构的无创工具。特征追踪超声心动图最近已成为评估左心室局部和整体功能的工具。我们旨在探讨超声心动图应变在CCTA电影剪辑中的适用性，并评估整体和局部应变参数是否与冠状动脉狭窄程度相关。
对61例连续患者的CCTA研究进行重建，以生成经典超声心动图长轴和短轴视图的电影图像。应用西门子速度向量成像（VVI）软件生成应变和位移结果。比较无冠状动脉疾病（CAD）或冠状动脉疾病不显著的患者与冠状动脉疾病显著的患者的容积和力学参数。最后，对冠状动脉狭窄程度与局部节段应变进行比较。
60例患者可生成心肌力学参数。两组的射血分数（EF）和左心室舒张末期容积（LVEDV）均在正常范围内。CAD组的VVI值较低（VVI左心室射血分数59±6对50±11，p = 0.0002）。该组的整体纵向应变和整体圆周应变均显著降低。与未受影响节段相比，受冠状动脉狭窄影响节段的局部节段应变较低。
虽然基于CT分割得出的左心室射血分数在各组之间没有差异，但冠状动脉狭窄显著的患者纵向和圆周收缩减弱。这表明将VVI应用于CCTA电影剪辑追踪可能有助于区分显著和不显著的冠状动脉狭窄，为CCTA的解剖学发现增添功能价值。
