超声左室心肌应变检查在非ST段抬高型急性冠状动脉综合征临床诊断中的应用OA

Objective:To explore the clinical significance of two-dimensional tracking speckle ultrasound(2D-STI)in detecting left ventricular stratified strain in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS).Methods:A total of 160 patients with acute chest pain diagnosed as NSTE-ACS who were admitted to Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2024 to May 2025 were se-lected as the NSTE-ACS group,and 80 volunteers without coronary artery lesions were selected as the control group.The left ventricular stratified strain parameters of the two groups of research subjects were compared.According to the degree of stenosis of the target vessel in coronary angiography,patients in the NSTE-ACS group were divided into the complete occlusion group and the stenosis group for stratified analysis.The Pearson analysis method was used to analyze the correlation between the Global Acute Coronary Event Registry(GRACE)risk score and the left ventricu-lar stratified strain parameters of NSTE-ACS patients.Results:The measured values of global longitudinal strain(LS),radial strain(RS),circumferential strain(CS)of the left ventricle,peak longitudinal systolic strain(GLS)of the left ventricular myocardium,and peak systolic strain(TLS)in the branch region of patients in the NSTE-ACS group were significantly lower than those in the control group,and the differences were statistically significant(all P＜0.05).There was no statistically significant difference in the measured values of apical torsion Angle(RA)between the NSTE-ACS group and the control group(P＞0.05).Among the 160 patients in the NSTE-ACS group,76 pa-tients had severe target vessel stenosis and 84 patients had mild stenosis.The measured values of LS,RS,CS,TLS and GLS in NSTE-ACS patients with severe coronary artery stenosis were significantly lower than those in NSTE-ACS patients with mild coronary artery stenosis,and the difference was statistically significant(all P＜0.05).There was no statistically significant difference in the RA measurement values between NSTE-ACS patients with severe coronary stenosis and those with mild coronary stenosis(P＞0.05).The GRACE risk score of patients in the NSTE-ACS group was significantly negatively correlated with the measured values of LS,RS,CS,TLS and GLS in the left heart of the patients(all P＜0.05).The area under the ROC curve AUC values of each index for diagnosing patients in the NSTE-ACS group were as follows[LS:AUC=0.605(0.510-0.699);RS:AUC=0.632(0.540-0.725);CS:AUC=0.646(0.554-0.738);TLS:AUC=0.643(0.552-0.735);GLS:AUC=0.608(0.515-0.702)],Combined indi-cators:AUC=0.894(0.842-0.947).Conclusion:The value of using each parameter of left ventricular stratified strain detected by 2D-STI alone in the diagnosis of patients with NSTE-ACS is not high.However,the combined application of various indicators significantly increases its diagnostic value,and comprehensive consideration can be made in clini-cal practice.