[Value of 3-dimensional speckle tracking imaging to quantify regional left ventricular function in patients with coronary artery disease].

Objective: To assess left ventricular (LV) strain by 3-dimensional speckle tracking imaging (3D-STI) in patients with coronary heart disease (CHD).

Methods: 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.

Results: 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) .

Conclusion: LV strain can be reliably quantified by 3D-STI. AS is a more sensitive parameter to detect coronary artery disease at early phase.