Evaluation of left ventricular function in patients with coronary heart disease by three-dimensional speckle tracking imaging combined with serum homocysteine

doi:10.3877/cma.j.issn.1674-0785.2022.05.010

Abstract

Abstract:

Objective

To evaluate the value of three-dimensional spot tracking imaging technology (3D-STI) combined with serum homocysteine (HCY) in the evaluation of left heart function in patients with coronary heart disease.

Methods

A total of 110 patients with coronary heart disease admitted to the People's Hospital of Xuancheng City from May 2018 to June 2021 were selected. All patients underwent coronary angiography to clarify the coronary blood flow. According to the degree of stenosis of the left circumflex branch, anterior descending branch, and single vessel of the left coronary artery, single vessels with stenosis ≥50% in diameter were included in the study group, and those with stenosis ＜50% in diameter was included in a control group. The relationship between left ventricular strain parameters and serum HCY was analyzed, and the receiver operating characteristic (ROC) curve was plotted to assess the value of HCY combined with strain parameters in evaluating left ventricular function in patients with coronary heart disease.

Results

All the 110 patients had coronary heart disease confirmed by coronary angiography. Sixty-five patients had single vessel with a diameter less than 50%, including 46 males and 19 females, with an average age of (65.41±10.52) years; 45 had single vessel stenosis ≥50%, including 37 males and 8 females, with an average age of (64.83±10.17) years. Peak A in the study group was higher than that in the control group [(75.58±12.65) cm/s vs (61.02±10.71) cm/s], and the difference was statistically significant (t=6.506, P＜0.001). The left ventricular short axis shortening rate (FS), left ventricular ejection fraction (LVEF), E peak, and E/A value in the study group were all lower than those in the control group (t=4.616,2.709,2.103, and 3.896, respectively; P＜0.05). The overall peripheral strain (GCS), overall long axial strain (GLS), overall radial strain (GRS), and overall area strain (GAS) in the study group were all lower than those in the control group (t=8.617, 10.535, 5.971, and 6.766, respectively; P＜0.001), and HCY was higher than that in the control group (t=4.915, P＜0.001). Pearson correlation analysis showed that HCY was negatively correlated with GCS, GLS, GRS, and GAS (r=-0.725, -0.682, -0.762, and -0.758, respectively; P＜0.001). The area under the curve (95% confidence interval) of GCS, GLS, GRS, GAS, HCY, and strain parameters combined with HCY in diagnosing CHD was 0.853 (0.751-0.954), 0.898 (0.802-0.993),0.731 (0.595-0.868), 0.847 (0.735-0.960), 0.863 (0.768-0.957), and 0.990 (0.973-1.000), respectively.

Conclusion

3D-STI strain parameters are closely correlated with HCY, and their combination can effectively evaluate left heart function in patients with coronary heart disease.

Key words: Coronary heart disease, Left heart function, Three-dimensional speckle tracking technique, Homocystoine, Strain parameter

Qi Cai, Yonghong Yong, Hua He, Tongsheng She, Hui Yu. Evaluation of left ventricular function in patients with coronary heart disease by three-dimensional speckle tracking imaging combined with serum homocysteine[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(05): 425-430.

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References 22

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组别	男/女	年龄（岁）	病程（年）	收缩压（mmHg）	舒张压（mmHg）	NYHA心功能分级（例）	基础性疾病度（例）
组别	男/女	年龄（岁）	病程（年）	收缩压（mmHg）	舒张压（mmHg）	Ⅰ/Ⅱ/Ⅲ	A/B/C
对照组（n=65）	46/19	65.41±10.52	7.15±1.49	136.50±10.49	83.05±8.17	18/26/21	32/25/37
研究组（n=45）	37/8	64.83±10.17	7.48±1.56	139.17±11.54	84.47±8.05	14/19/12	22/19/28
χ²/t/Z值	1.883	0.288	1.120	1.260	0.902	0.421	0.084
P值	0.170	0.774	0.265	0.211	0.369	0.810	0.959

组别	男/女	年龄（岁）	病程（年）	收缩压（mmHg）	舒张压（mmHg）	NYHA心功能分级（例）	基础性疾病度（例）
组别	男/女	年龄（岁）	病程（年）	收缩压（mmHg）	舒张压（mmHg）	Ⅰ/Ⅱ/Ⅲ	A/B/C
对照组（n=65）	46/19	65.41±10.52	7.15±1.49	136.50±10.49	83.05±8.17	18/26/21	32/25/37
研究组（n=45）	37/8	64.83±10.17	7.48±1.56	139.17±11.54	84.47±8.05	14/19/12	22/19/28
χ²/t/Z值	1.883	0.288	1.120	1.260	0.902	0.421	0.084
P值	0.170	0.774	0.265	0.211	0.369	0.810	0.959

组别	LVDds（cm）	LVDs（cm）	FS（%）	LVEF（%）	E峰（cm/s）	A峰（cm/s）	E/A值
对照组	5.14±1.24	3.77±1.03	27.31±3.68	51.65±8.47	58.28±9.76	61.02±10.71	0.95±0.34
研究组	5.45±1.36	4.13±1.45	24.23±3.06	47.59±6.50	54.14±10.69	75.58±12.65	0.73±0.20
t值	1.239	1.100	4.616	2.709	2.103	6.506	3.896
P值	0.218	0.274	＜0.001	0.008	0.038	＜0.001	＜0.001

组别	LVDds（cm）	LVDs（cm）	FS（%）	LVEF（%）	E峰（cm/s）	A峰（cm/s）	E/A值
对照组	5.14±1.24	3.77±1.03	27.31±3.68	51.65±8.47	58.28±9.76	61.02±10.71	0.95±0.34
研究组	5.45±1.36	4.13±1.45	24.23±3.06	47.59±6.50	54.14±10.69	75.58±12.65	0.73±0.20
t值	1.239	1.100	4.616	2.709	2.103	6.506	3.896
P值	0.218	0.274	＜0.001	0.008	0.038	＜0.001	＜0.001

组别	GCS	GLS	GRS	GAS	HCY（ng/ml）
对照组	-19.71±2.73	-17.51±2.21	47.63±6.99	-28.33±3.65	18.57±2.14
研究组	-15.45±2.56	-13.69±2.04	41.25±6.82	-26.14±3.30	21.39±3.85
t值	8.252	9.195	2.518	3.216	4.915
P值	＜0.001	＜0.001	0.013	0.002	＜0.001

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