Differential Effects of Coronary Artery Stenosis on Myocardial Function: The Value of Myocardial Strain Analysis for the Detection of Coronary Artery Disease
Differential Effects of Coronary Artery Stenosis on Myocardial Function: The Value of Myocardial Strain Analysis for the Detection of Coronary Artery Disease
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DOI：
10.1016/j.echo.2011.03.007
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发表时间：
2011-07-01
影响因子：
6.5
通讯作者：
Friedman, Zvi
中科院分区：
文献类型：
--
作者：
Shimoni, Sara;Gendelman, Gera;Friedman, Zvi
背景：斑点追踪成像是一种评价左心室功能和缺血性改变的新方法。本研究的目的是评估二维纵向应变在心绞痛住院患者纵向LV功能障碍检测和冠状动脉疾病（CAD）识别中的预测价值。扩展二维应变软件，以允许分析整个左心室的大量纵向应变迹线，并生成收缩期峰值应变（PSS）直方图。左心室和每个冠状动脉区域的值。在每个直方图中，确定10%最差应变值（PSS（10%））的值。分析了97例因心绞痛住院且LV功能正常的患者（接受冠状动脉造影）和51例CAD可能性较低的患者的整体应变、节段性PSS和PSS（10%）。超声心动图进行了2.9 +/- 2 daysado.Results：69例患者有显着的CAD冠状动脉造影。在所有应变参数中观察到有和没有CAD的患者之间的显著差异。PSS 10%显示出检测CAD的最佳准确性，受试者工作特征曲线下面积为0.85。整体应变和节段性PSS的曲线下面积分别为0.80和0.76。PSS（10%）的最佳截止值为-13.9%，敏感性和特异性分别为86%和75%。PSS 10%优于节段性PSS在检测CAD在each coronary territory.Conclusions：在心绞痛住院患者有显着的CAD冠状动脉造影，纵向收缩功能受损。直方图分析提高了纵向应变分析检测整体和区域功能受损的准确性。（J Am Soc Echocardiogr 2011; 24：748-57.）
Background: Speckle-tracking imaging is a novel method for assessing left ventricular (LV) function and ischemic changes. The aim of this study was to assess the predictive value of two-dimensional longitudinal strain in the detection of longitudinal LV dysfunction and the identification of coronary artery disease (CAD) in patients hospitalized with angina.Methods: Two-dimensional strain software was extended to allow the analysis of numerous longitudinal strain traces in the entire left ventricle and generate a histogram of peak systolic strain (PSS) values for the left ventricle and for each coronary territory. In each histogram, the value of the 10% worst strain values (PSS(10%)) was determined. Global strain, segmental PSS, and PSS(10%) were analyzed in 97 patients hospitalized with angina and had normal LV function, who underwent coronary angiography, and 51 patients with low probability of CAD. Echocardiography was performed 2.9 +/- 2 days after admission.Results: Sixty-nine patients had significant CAD on coronary angiography. Significant differences were observed in all strain parameters between patients with and without CAD. PSS10% showed the best accuracy in detecting CAD, with an area under the receiver operating characteristic curve of 0.85. The areas under the curve for global strain and segmental PSS were 0.80 and 0.76, respectively. The optimal cutoff for PSS(10%) was -13.9%, with sensitivity and specificity of 86% and 75%, respectively. PSS10% was better than segmental PSS in the detection of CAD in each coronary territory.Conclusions: In patients hospitalized with angina who have significant CAD on coronary angiography, longitudinal systolic function is impaired. Histogram analysis improved the accuracy of longitudinal strain analysis in detecting global and regional impaired function. (J Am Soc Echocardiogr 2011; 24: 748-57.)