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Quantitative assessment of left ventricular systolic function in patients with coronary heart disease by velocity
Zu-rong Yang1, Qi-chang Zhou, Ling Lee
1Department of Ultrasonography, Central South University, Changsha, Hunan, People's Republic of China.
Insights
Syngo velocity vector imaging (VVI) effectively assesses left ventricular function in coronary atherosclerotic heart disease (CAD) patients. VVI provides reproducible measurements of strain, strain rate, and timing, aiding in the detection of myocardial ischemia and infarction.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Coronary atherosclerotic heart disease (CAD) significantly impacts left ventricular (LV) systolic function.
- Accurate assessment of LV longitudinal systolic function and asynchrony is crucial for managing CAD patients.
Purpose of the Study:
- To evaluate the utility of syngo velocity vector imaging (VVI) in assessing LV longitudinal systolic function and asynchrony in patients with CAD.
- To determine the diagnostic performance of VVI-derived parameters for detecting myocardial ischemia and infarction.
Main Methods:
- A study involving 79 CAD patients and 28 controls, utilizing syngo velocity vector imaging (VVI).
- Myocardial segments were categorized as ischemic, infarcted, nonischemic, or normal based on coronary arteriography and ECG.
- Key parameters measured included systolic peak strain (Smax), systolic strain rate (SRmax), time to peak strain (PTs), and time to peak strain rate (PTsr).
Main Results:
- VVI successfully analyzed 96.5% of myocardial segments.
- Impaired Smax and SRmax were observed in ischemic and infarcted segments of CAD patients.
- Specific cutoff values for strain and strain rate demonstrated high sensitivity and specificity for detecting ischemia and infarction. PTs and PTsr were prolonged in affected segments.
Conclusions:
- VVI offers a reproducible method for measuring longitudinal strain, strain rate, and peak times in CAD patients.
- Defined cutoff values for strain and strain rate are valuable for identifying ischemic and infarcted myocardium.
- PTs and PTsr measurements show potential for estimating myocardial asynchrony in CAD.
Objective:
To assess the left ventricular (LV) longitudinal systolic function and asynchrony in patients with coronary atherosclerotic heart disease (CAD) by syngo velocity vector imaging (VVI).
Methods:
Twenty-eight control subjects and 79 patients with CAD were examined, including 28 patients with myocardial infarction, 26 patients with coronary lumen stenosis <50%, and 25 patients with myocardial ischemia. According to the results of coronary arteriography and electrocardiogram (ECG), the myocardial segments of the LV of CAD patients were divided into four groups: ischemic, infarcted, nonischemic, and normal. Dynamic imaging was performed on all subjects. The systolic peak strain (Smax), systolic strain rate (SRmax), time to peak strain (PTs), and time to peak strain rate (PTsr) in every cardiac cycle were measured.
Results:
A total of 1,253 out of 1,712 (96.5%) segments were successfully analyzed with VVI. Smax and SRmax of the ischemic and infarcted segments were impaired in CAD patients. Optimal sensitivity and specificity were obtained with strain and strain rate cutoffs of -14.08% and -0.83 s(-1) , respectively, for detecting ischemic segments and -6.65% and -0.38 s(-1) , respectively, for detecting infarcted segments. The PTs and PTsr were significantly longer in the ischemic and infarcted segments compared to those of the control group.
Conclusions:
Utilizing VVI, the longitudinal strain, strain rate, and peak time in CAD patients are easy to obtain and reproducible. Strain and strain rate cutoff values of abnormal myocardium are valuable for detecting ischemia and infarction. The PTs and PTsr values possibly estimate myocardium asynchrony in CAD patients.
