AIM To explore the value of non-invasive left ventricular pressure-strain loop (LVPSL) in evaluating myocardial work in patients with coronary atherosclerotic heart disease (CAD) of different degrees of coronary stenosis.
METHODS One hundred and thirty patients who were clinically diagnosed with suspected CAD and underwent coronary angiography from December 2019 to October 2021 in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Hunan Traditional Chinese Medicine College were selected prospectively for routine echocardiography and LVPSL examination. According to the results of coronary angiography, the patients were divided into group without coronary artery stenosis (n=33) and group with coronary artery stenosis (n=97) according to the coronary artery Gensini score. The group with coronary artery stenosis was further divided into three subgroups: mild stenosis group (Gensini score <25, n=37), moderate stenosis group Gensini score (25~50), n=32 and severe stenosis group (Gensini score >50, n=28). Simultaneous cardiac conductance was connected to collect conventional echocardiography parameters and three cardiac cycles were taken from the left ventricular apical four-chamber heart, three-chamber heart and two-chamber heart section to obtain the overall longitudinal strain (GLS) of the left ventricle in the mode of two-dimensional speckle tracking imaging. Left ventricular global work index (GWI), global effective work (GCW), global ineffective work (GWW) and global work efficiency (GWE) were evaluated by LVPSL, and the effects of different degrees of coronary artery stenosis on the left ventricular systolic function and myocardial work were compared.
RESULTS Compared with the group without coronary artery stenosis, the GLS decreased, GWI decreased, GCW decreased, GWE decreased and GWW increased (all P<0.01) in the group with mild coronary artery stenosis; In the group of moderate coronary artery stenosis, GLS decreased, GWI decreased, GCW decreased, GWE decreased and GWW increased (all P<0.01); In severe coronary artery stenosis group, GLS, GWI, GCW, GWE decreased and GWW increased (all P<0.01). Compared with mild coronary artery stenosis, GLS,GWI, GCW, GWE decreased and GWW increased in moderate coronary artery stenosis group (all P<0.01); In severe coronary artery stenosis group, GLS decreased, GWI decreased, GCW decreased, GWE decreased and GWW increased (all P<0.01); Compared with moderate coronary artery stenosis, GLS, GWI, GCW, GWE decreased and GWW increased in severe coronary artery stenosis group (all P<0.01). The Gensini score of coronary artery stenosis group was negatively correlated with the absolute value of GLS, GWI, GCW, GWE (r=−0.554, −0.661, −0.619, −0.829), and positively correlated with GWW (r=0.718), of which the correlation with GWE was the highest.
CONCLUSION GWI, GCW, GWE and GWW measured by LVPSL technique can quantitatively analyze the myocardial work of CAD patients with different degrees of coronary artery stenosis and the correlation between GWE and Gensini score is superior to that of GLS.
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