血流向量成像技术联合二维斑点追踪技术评估冠心病患者增强型体外反搏治疗后左心功能早期变化的价值OA

Objective To investigate the value of vector flow mapping(VFM)combined with two-dimensional speckle tracking imaging(2D-STI)in evaluating early changes in left ventricular function indi-ces after enhanced external counterpulsation(EECP)therapy in patients with coronary artery disease(CAD).Methods A total of 84 CAD patients with normal left ventricular ejection fraction(LVEF)trea-ted in the Department of Cardiology,the Second Affiliated Hospital of Zhengzhou University,were randomly divided into EECP group(n=42)and control group(n=42).The EECP group received pharmacological therapy combined with EECP,while the control group received pharmacological therapy alone.Echocardiography was performed at admission and at 3.5 and 7 weeks of treatment to measure con-ventional cardiacfunction parameters in all subjects.VFM and 2D-STI techniques were used to ana-lyze the images,and the following parameters were measured:intraventricular pressure difference(IVPD)and pressure gradient(IVPG)during isovolumic relaxation(IR),rapid filling(RF),slow filling(SF),and atrial contraction(AC)phases,as well as global longitudinal strain(GLS)of the left ventricle.The differences and characteristics of these indices between the two groups at each time point were analyzed.Results At 3.5 weeks of treatment,the absolute values of GLS in both the EECP and control groups increased compared with those at admission,and the IVPD and IVPG during IR,RF and AC phases also increased,with statistically significant differences(P＜0.05).No significant differences were observed in the Tei index,maximal velocity(e')at the mi-tral annulus(interventricular septum and left ventricular lateral wall),E/e',left atrial volume in-dex(LAVi),peak early diastolic mitral velocity(E),peak late diastolic mitral velocity(A),E/A,or LVEF compared with those at admission(P＞0.05).At 7 weeks of treatment,the absolute val-ues of GLS,IVPD,and IVPG in both groups further increased compared with those at 3.5 weeks,while the Tei index decreased,e'increased,and E/e'decreased,with statistically significant differ-ences(P＜0.05).At 7 weeks,significant differences were observed between the two groups in IVPD-IR,IVPD-RF,IVPD-SF,IVPD-AC,IVPG-IR,IVPG-RF,IVPG-SF,IVPG-AC,GLS,Tei index,and E/e'(P＜0.05).The IVPD and IVPG during RF and AC phases were positively corre-lated with e'and GLS and negatively correlated with E/e',with more pronounced correlations ob-served compared with other periods.Conclusion VFM combined with 2D-STI can effectively evalu-ate early changes in left ventricular function after EECP therapy in patients with CAD.