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ȣ - 520747 219 |
| Improvement in Regional Myocardial Function Assessed by Strain Rate Imaging in Patients with Coronary Artery Disease but normal wall motion Undergoing Percutaneous Coronary Intervention. |
| 경희대학교병원 |
| 손주웅, 하상진,김우식,황석재,손일석,김수중,조진만,김명곤,김종진,배종화,김권삼 |
Background : In patients with regional and global left ventricular (LV) function interpreted as normal by routine gray scale 2D echocardiogram but significant coronary artery stenosis, the strain rate (SR) imaging technique can demonstrate decreased regional LV function. The purpose of this study was to examine the regional myocardial dysfunction in patients with normal LV wall motion but angiographically significant coronary artery stenosis and compare strain and strain rate between before percutaneous coronary intervention (PCI) and 6 months follow-up using SR imaging.
Methods : Standard echocardiography and SR imaging were performed in 22 patients with stable angina pectoris with angiographically significant coronary artery stenosis (> 70% narrowing in the major coronary artery) but normal wall motion before PCI (Group A) and after 6 months later (groupB). We measured left ventricular (LV) longitudinal strain and strain rate in global and 396 regional segments (147 ischemic and 249 nonischemic).
Results: All analyzed strain data were decreased in the ischemic segments than nonischemic segments. PCI caused a significant increase in peak systolic strain and peak early diastolic strain rate but not peak systolic strain rate and peak late diastolic strain rate in the ischemic segments after 6 months follow-up.
Conclusion: In patients with significant coronary artery stenosis but normal LV function assessed by routine gray scale 2D echocardiogram, SR imaging demonstrated the regional LV dysfunction in the ischemic segments and improvement in regional LV dysfunction after PCI. Therefore, SR imaging is a sensitive and accurate tool in myocardial dysfunction assessment
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Peak systolic strain
(SS) |
Peak systolic strain rate (SSR) |
Peak early diastolic strain rate (ESR) |
Peak late diastolic strain rate (ASR) |
|
Group A |
Group B |
Group A |
Group B |
Group A |
Group B |
Group A |
Group B |
|
Ischemic segments |
10.9±5.0 |
15.9±6.8* |
0.95±0.36 |
1.01±0.42 |
0.72±0.48 |
1.02±0.57* |
1.13±0.59 |
1.06±0.43 |
|
Nonischemic segments |
23.1±6.3 |
22.8±6.4 |
1.48±0.48 |
1.30±0.51 |
1.61±0.77 |
1.44±0.77 |
1.44±0.65 |
1.25±0.57 |
Values given are mean ± standard deviation. Values of strain was percent (%) and values of strain rate was 1/sec.
*: p<0.01, p value was analyzed between Group A (before PCI) and Group B (6month later)
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