Value of non-invasive left ventricular myocardial work in the diagnosis of myocardial ischemia in coronary heart disease
10.12025/j.issn.1008-6358.2024.20231344
- VernacularTitle:无创左室压力应变曲线在冠心病心肌缺血诊断中的价值
- Author:
Yingjie ZHAO
1
,
2
;
Furong HE
3
,
4
;
Wei HE
5
;
Weifeng GUO
1
,
6
;
Shihai ZHAO
1
,
6
;
Zhenyi GE
1
,
2
;
Zhifeng YAO
7
;
Haiyan CHEN
1
,
2
;
Cuizhen PAN
1
,
2
;
Xianhong SHU
1
,
2
Author Information
1. Shanghai Institute of Medical Imaging, Shanghai 200032, China
2. Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
3. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
4. School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
5. Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
6. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
7. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
- Keywords:
echocardiography;
pressure strain loop;
fraction flow reservation;
coronary artery disease;
myocardial ischemia
- From:
Chinese Journal of Clinical Medicine
2024;31(3):411-419
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the diagnostic value of myocardial work related parameters in coronary ischemia patients with coronary artery disease (CAD) coronary ischemia using non-invasive left ventricular pressure strain loop (PSL), taking fraction flow reservation (FFR) as the gold standard. Methods From December 2020 to December 2021, 53 clinically suspected CAD patients were prospectively enrolled. All patients underwent echocardiography, invasive coronary angiography and FFR measurement. According to the results of coronary angiography, patients were divided into myocardial ischemia group (n=24, FFR≤0.80) and non-myocardial ischemia group (n=29, FFR＞0.80). PSL was used for off-line analysis to obtain the global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE) , global positive work( GPW) , and global systolic constructive work (GSCW) and other myocardial work parameters. The differences of parameter values between the two groups were compared. The diagnostic efficacy of work parameters in myocardial ischemia was analyzed by ROC curve. Results Compared with the non-myocardial ischemia group, GWI, GCW, GPW and GSCW were significantly decreased in the myocardial ischemia group at the 18-, 16-, and 12-segment levels (P＜0.001). The ROC curve showed that the AUC results of GWI, GCW, GPW, GSCW at the 18-segment level were 0.803(95%CI 0.679-0.927), 0.807(95%CI 0.687-0.928), 0.822(95%CI 0.708-0.936), 0.819(95%CI 0.703-0.935). The optimal cut-off value of GWI was 1 676.3 mmHg%, and the sensitivity, specificity and accuracy of predicting myocardial ischemia were 70.8%, 86.2% and 79.2%, respectively. The optimal cut-off value of GCW was 1 999.4 mmHg%, and the sensitivity, specificity and accuracy of predicting myocardial ischemia were 75.0%, 82.8% and 79.2%, respectively. Conclusions Analyzing myocardial work using PSL has good significance for screening suspected myocardial ischemia in CAD patients.
