Clinical study on the evaluation of left ventricular strain in patients with non-ST-segment elevation myocardial infarction by two-dimensional speckle tracking imaging

doi:10.3877/cma.j.issn.1674-6880.2017.01.002

Abstract

Abstract:

Objective

To investigate the clinical application of two-dimensional speckle tracking imaging in assessing the left ventricular regional and global systolic strain in patients with non-ST-segment elevation myocardial infarction (NSTEMI).

Methods

This study retrospectively analyzed 82 NSTEMI patients in Chinese PLA General Hospital from 2011 to 2015 as NSTEMI group and 58 healthy people served as the control group. The two-dimensional dynamic images of apical planes in four chamber, two chamber and three chamber were acquired by speckle tracking imaging; the values of left ventricular regional and global strain were obtained. Left ventricular ejection fraction (LVEF) was calculated by the modified Simpson’s rule.

Results

LVEF of the NSTEMI group showed no significant difference compared with the control group [(57 ± 9)% vs. (59 ± 7)%, t = 1.651, P = 0.101]. However, compared with the control group, the peak systolic longitudinal strains of each segment at apical, middle and basal levels and left ventricular global strain in the NSTEMI group decreased significantly [(-13 ± 5)% vs. (-18 ± 4)%,(-14 ± 4)% vs. (-19 ± 3)%, (-14 ± 5)% vs. (-18 ± 4)%, (-14 ± 4)% vs. (-18 ± 3)%; t=6.533, 7.738, 5.025, 7.761; all P < 0.001].

Conclusion

Two dimensional speckle tracking imaging can assess left ventricular longitudinal strains in patients with NSTEMI, and accurately evaluate the left ventricular regional and global systolic function at the early stage.

Key words: Echocardiography, Speckle tracking, Myocardial strain, Non-ST-segment elevation myocardial infarction

Fangfang Guo, Jiahong Wang, Haifeng Yu, Xianyong Huang. Clinical study on the evaluation of left ventricular strain in patients with non-ST-segment elevation myocardial infarction by two-dimensional speckle tracking imaging[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2017, 10(01): 9-12.

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References 16

1	中华医学会心血管病分会. 非ST段抬高急性冠脉综合征诊断和治疗指南[J]. 中华心血管病杂志，2012，40(5):353-367.
2	中国医师协会急诊医师分会，中华医学会心血管病学分会，中华医学会检验医学分会. 急性冠脉综合征急诊快速诊疗指南[J/CD]. 中华危重症医学杂志（电子版），2016，9(2):73-80.
3	周发展，武君，张春玲，等. 替罗非班应用于急诊经皮冠状动脉介入治疗对急性心肌梗死患者心肌灌注和内皮功能的影响[J/CD]. 中华危重症医学杂志（电子版），2016，9(1):3-8.
4	林冬铭，黄抒伟，窦丽萍，等. 急性ST段抬高型心肌梗死患者围术期阿托伐他汀的应用观察[J/CD]. 中华危重症医学杂志（电子版），2014，7(6):50-52.
5	Amundsen BH, Helle-Valle T, Edvardsen T, et al. Noninvasive myocardial strain measurement by speckle tracking echocardiography: validation against sonomicrometry and tagged magnetic resonance imaging [J]. J Am Coll Cardiol, 2006, 47 (4): 789-793.
6	李丹，张敏郁，高宇，等. 三维斑点追踪成像技术评价冠状动脉不同程度狭窄心肌应变[J/CD]. 中华医学超声杂志（电子版），2016，13(3):169-177.
7	郭薇，林建婷，卢荔红，等. 三维超声斑点追踪成像评价冠心病患者左室收缩功能[J]. 中国超声医学杂志，2016(4):304-306.
8	杨文辰，于英利，王忠鑫，等. 二维斑点追踪成像技术评价高血压患者左心室收缩功能[J]. 中国现代医学杂志，2013，23(26):70-74.
9	Granger CB, Goldberg RJ, Dabbous O, et al. Predictors of hospital mortality in the global registry of acute coronary events[J]. Arch Intern Med, 2003, 163 (19): 2345-2353.
10	Mor-Avi V, Lang RM, Badano LP, et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography[J]. Eur J Echocardiogr, 2011, 12 (3): 167-205.
11	孙由静，汪芳，张瑞生，等. 探讨三维斑点追踪技术对冠心病早期诊断的价值[J]. 中国超声医学杂志，2016(4):320-323.
12	初志辉，瞿玲谦，纽红音，等. 二维斑点追踪定量评价节段性室壁运动的分析[J]. 南通大学学报（医学版），2011，31(6):472-474.
13	张璐，刘加强，智光，等. 掌上心脏超声在老年心血管病患者中的应用价值[J]. 中华老年心脑血管病杂志，2016，18(9):930-933.
14	张小花，姜志荣，孙安华，等. 实时三维超声心动图和二维斑点追踪技术对冠心病患者左心室收缩同步性的评价[J]. 中国超声医学杂志，2016(10):901-904.
15	Dahlslett T, Karlsen S, Grenne B, et al. Early assessment of strain echocardiography can accurately exclude significant coronary artery stenosis in suspected non-ST-segment elevation acute coronary syndrome[J]. J Am Soc Echocardiogr, 2014, 27 (5): 512-519.
16	李效寅，李群策. 斑点追踪技术对冠心病患者PCI术治疗前后左室收缩功能的应用价值[J]. 医学影像学杂志，2016(1):51-54.

组别	例数	年龄（岁）	性别（男/女）	体质量（kg）	心脏二维指标
组别	例数	年龄（岁）	性别（男/女）	体质量（kg）	心率（次/min）	收缩压（mmHg）	舒张压（mmHg）	心脏室间隔厚度（mm）	左心室后壁厚度（mm）	左心室舒张末期前后径（mm）
对照组	58	55 ± 15	36/22	64 ± 13	72 ± 11	109 ± 18	71 ± 9	8.9 ± 0.8	8.7 ± 0.7	46 ± 4
NSTEMI组	82	58 ± 14	47/35	65 ± 10	75 ± 14	112 ± 19	73 ± 10	9.1 ± 0.9	8.9 ± 0.6	47 ± 5
t/χ²值	?	1.097	1.080	0.466	1.489	1.178	1.362	1.355	1.812	0.911
P值	?	0.272	0.694	0.642	0.139	0.241	0.176	0.178	0.072	0.364

组别	例数	年龄（岁）	性别（男/女）	体质量（kg）	心脏二维指标
组别	例数	年龄（岁）	性别（男/女）	体质量（kg）	心率（次/min）	收缩压（mmHg）	舒张压（mmHg）	心脏室间隔厚度（mm）	左心室后壁厚度（mm）	左心室舒张末期前后径（mm）
对照组	58	55 ± 15	36/22	64 ± 13	72 ± 11	109 ± 18	71 ± 9	8.9 ± 0.8	8.7 ± 0.7	46 ± 4
NSTEMI组	82	58 ± 14	47/35	65 ± 10	75 ± 14	112 ± 19	73 ± 10	9.1 ± 0.9	8.9 ± 0.6	47 ± 5
t/χ²值	?	1.097	1.080	0.466	1.489	1.178	1.362	1.355	1.812	0.911
P值	?	0.272	0.694	0.642	0.139	0.241	0.176	0.178	0.072	0.364

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