Quantitative assessment of left ventricular wall movement in patients with lesions of left anterior descending coronary artery lesion using velocity vector imaging

XIE Jun; ZHANG Kang

doi:10.3969/j.issn.1001-9448.2017.13.012

Abstract：Objective Using velocity vector imaging (VVI) to assess patients with left anterior descending coronary artery (LAD) lesion, thus to investigate the correlation between left regional ventricular systolic function and the degree of coronary artery disease (CAD).Methods Twenty control subjects and 40 patients with CAD were examined, including 20 patients with myocardial infarction and 20 patients with myocardial ischemia.Dynamic imaging was performed on all subjects.Standard apical four-chamber view, two-chamber view, apical left ventricular long-axis view and parasternal short-axis views at the level of mitral valve, papillary muscle and apex were acquired with Siemens Sequoia 2000 ultrasound system.The systolic peak radial strain (RS), circumferential strain (CS), longitudinal strain (LS) and peak apical rotation, peak basal rotation, peak apical rotation rate, and peak basal rotation rate were measured.Results Compared to control group, the systolic peak longitudinal strain, circumferential strain, and radial strain of the ischemic and infarcted segments were impaired in CAD patients (P<0.05).Optimal sensitivity and specificity were obtained with longitudinal strain, circumferential strain and radial strain with the cutoffs of-17.58%,-20.52% and 36.26%, respectively, for detecting ischemic segments;and-15.86%,-18.30% and 34.60%, respectively, for detecting infarcted segments.In infarcted group, the systolic peak rotation and rotation rate of infarcted segments were significantly lower than those in control group (P<0.05).In ischemic group, the systolic peak rotation and rotation rate of ischemic segments were not significantly different from those in control group (P>0.05).Conclusion The regional systolic function is reduced by VVI while the global function was normal and no segmental wall motion abnormality in patients with CAD.It is more useful to calculate the systolic peak longitudinal strain, and circumferential strain by VVI for estimating the LAD stenosis.VVI can localize and quantitatively analyze the range of myocardial ischemia.