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Assessment of myocardial segmental function with coronary artery stenosis in multi-vessel coronary disease patients

M-Y Xie1, Q Lv, J Wang

  • 1Department of Ultrasound Imaging, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei, China. jiabaoyin-xf1227@163.com.

European Review for Medical and Pharmacological Sciences
|May 11, 2016
PubMed

Insights

Coronary artery stenosis impairs myocardial systolic function, particularly longitudinal and radial mechanics, even with normal wall motion. This study quanties systolic dysfunction in multi-vessel coronary artery disease using two-dimensional speckle tracking imaging.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Coronary artery disease (CAD) is a leading cause of heart dysfunction.
  • Assessing left ventricular systolic function is crucial for managing CAD.
  • Two-dimensional speckle tracking imaging (STI) offers quantitative analysis of myocardial mechanics.

Purpose of the Study:

  • To investigate the impact of varying degrees of coronary artery stenosis on left ventricular systolic dysfunction.
  • To quantitatively analyze regional myocardial systolic function (longitudinal, radial, circumferential) in patients with CAD using STI.
  • To correlate stenosis severity with systolic dysfunction in patients with normal wall motion.

Main Methods:

  • Enrolled 43 patients with normal wall motion-multi vessel coronary artery disease (NWM-MVD) and 42 controls.
  • Acquired 2D STI of the left ventricle (apical long axis, short axis).
  • Quantified longitudinal, radial, and circumferential systolic strain (SL, SR, SC) and strain ratio (SrL, SrR, SrC) in 18 myocardial segments, categorized by stenosis severity (≤50%, 50%-99%, ≥99%).

Main Results:

  • Significant decreases in SL and SR were observed in all CAD groups (B, C, D) compared to controls (p <0.05).
  • SL further decreased in group D (≥99% stenosis) compared to group C (50%-99% stenosis) (p <0.05).
  • Circumferential strain (SC) showed no significant difference, while strain ratios (SrL, SrR, SrC) decreased significantly across CAD groups compared to controls.

Conclusions:

  • Myocardial systolic function, especially longitudinal and radial, is impaired in multi-vessel CAD patients even with normal wall motion.
  • STI can detect subtle systolic dysfunction related to coronary stenosis severity.
  • Bradycardia may serve as a compensatory mechanism in NWM-MVD patients.
Abstract

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