Value of three-dimensional speckle tracking imaging for quantitative assessment of global left ventricular systolic function in patients with coronary heart disease

Objective To explore the accuracy of three-dimensional speckle tracking imaging (3D-STI) in quantitative coronary evaluation of (CHD) patients′ left ventricular global systolic function. Methods Sixty-eight CHD patients were divided into three groups according to the coronary artery angiography (CAG) results: 32 cases in severe stenosis group, 23 cases in moderate stenosis group, and 13 cases in mild stenosis group. Thirty gender-age-matched healthy subjects(control group) were enrolled in this study. All patients underwent 2D-echocardiography and real-time three-dimensional echocardiography(3DE). The global longitudinal strain(GLS), global radial strain(GRS), global circumferential strain(GCS), global area strain(GAS), global area strain rate(GASrate) and 3D global LV strain(3D-Strain) were analyzed using 3D-STI. Correlation between strain measurements and left ventricular ejection fraction(LVEF) by simpson method, 3D-LVEF by 3DE were assessed using linear regression analysis. Results All 3D-STI parameters in the severe stenosis group were significant decreased compared with the other groups. GLS, GRS, GCS, GAS, 3D-Strain of moderate stenosis group shown more significant decrease than both mild stenosis group and control group(P<0.05). Strong correlations were demonstrated in all 3D-STI parameters between 3D-LVEF and LVEF. The strongest correlation was observed between GAS with 3D-LVEF in severe stenosis group(r=-0.910, P<0.05). Intraobserver and interobserver reliability of GAS was better than other parameters. Conclusions Global strain of 3D-STI can quantitatively evaluate the global LV function in CHD patients, and GAS is more sensitive and reproducible than other parameters. Key words: Echocardiography, three-dimensional; Coronary stenosis; Ventriular function, left; Three-dimensional speckle tracking imaging