title: Four-dimensional speckle tracking for assessing improvement in left ventricular contractility after coronary angioplasty.
abstract: The objective of the study was to identify and quantify the potential improvement of left ventricular contractility after percutaneous transluminal coronary angioplasty (PTCA) using 4-dimensional (4D) speckle tracking echocardiography (4D STE). We investigated 41 patients with coronary disease by 4D STE pre- and 24 hours postcoronarography with (n = 18) or without (n = 23) PTCA. The 4D STE visualizes in real time the myocardium strain on 2- and 4-chamber apical views and on 3 transverse views of the left ventricle. Average and total strain of the left ventricle were measured. Of the 18 PTCA patients, 15 showed significant increase in left ventricle mean (+15 ± 6) and total strain (240 ± 100), which corresponded to an increase of 93% ± 55% from precoronarography, whereas the remainder showed no change. The total strain corresponded to 33% ± 10% (before PTCA) and 59% ± 11% (post PTCA) of the estimated normal strain for each patient. Strain improved in 70% of the segment downstream from the stent, and there was a negative correlation between the amplitude of the mean and total strain improvements after 24 hours and the mean and total strain values before PTCA. In the non-PTCA group, 21 of the 23 patients showed no changes in strain, whereas 2 showed improvement. The 4D STE showed significant improvements in left ventricular contractility in more than 70% of the areas downstream from the PTCA segment. This corresponded to an increase in the initial contractility by approximately 93% ± 55%; however, the myocardium contractility remained approximately 59% of normal level. No changes were seen in patients without PTCA.
authors.affiliation: Science de Médecine Nucléaire et Ultrasons, CHU Trousseau, Tours, France. arbeille@med.univ-tours.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Arbeille
authors.forename: Denis
authors.initials: D
authors.lastname: Angoulvant
authors.forename: Kathreen
authors.initials: K
authors.lastname: Zuj
authors.forename: Jeanne
authors.initials: J
authors.lastname: Patier
authors.forename: Bernard
authors.initials: B
authors.lastname: Desveaux
authors.forename: Laurent
authors.initials: L
authors.lastname: Quilliet
authors.forename: Bernard
authors.initials: B
authors.lastname: Charbonnier
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D019561:Echocardiography, Four-Dimensional; D006801:Humans; D009200:Myocardial Contraction; D016277:Ventricular Function, Left