AIM To evaluate changes in myocardial work in patients with coronary artery stenosis by left ventricular pressure strain loop (LV PSL) and to explore the clinical value of myocardial work parameters in the diagnosis of coronary heart disease.
METHODS One hundred and eleven patients with suspected coronary heart disease were divided into two groups according to their coronary angiography results: a control group (33 patients without coronary artery stenosis or stenosis < 50%) and 78 patients in a coronary heart disease (CHD) group (at least one coronary artery stenosis ≥ 50%), who were subdivided into a CHD group with regional wall motion abnormality (26 patients) and a CHD group without regional wall motion abnormality (52 patients). Dynamic images of the apical four-chamber, two-chamber and left ventricular long-axis sections were collected, using Echo PAC workstation for whole left ventricular global longitudinal strain (GLS), entering the myocardial work (MW) analysis model, and eventually getting global MW index (GWI), constructive MW (GCW), wasted MW (GWW) and MW efficiency (GME).
RESULTS Compared with those in control group, GLS, GWI, GCW and GME in CHD group all decreased and GWW increased (P < 0.05). GLS and GWW increased in CHD group with regional wall motion abnormality (P < 0.05). GWI, GCW and GME decreased (P > 0.05), and GLS decreased and GWW increased (P < 0.05) in CHD group without regional wall motion abnormality. The ROC curve showed that the area under the curve of GWI, GCW, GWW and GME was 0.36, 0.40, 0.75 and 0.27 respectively. The cut-off GWW value was 70.5%, the sensitivity and specificity of predicting coronary heart disease were respectively 67% and 97%, and the Youden index was 0.64.
CONCLUSION Left ventricular pressure strain loop is able to quantitatively analyze myocardial work in patients with coronary heart disease. GWW is a more sensitive indicator of myocardial work and ventricular function changes in patients with coronary heart disease.
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