Evaluation of left ventricular systolic function in patients with acute ST segment elevation myocardial infarction treated by Tongxinluo after percutaneous coronary intervention by tissue mitral annulus displacement technique

Abstract

Purpose: We aimed to investigate the value of the tissue mitral annular displacement (TMAD) technique in evaluating left ventricular systolic function in patients with acute ST segment elevation myocardial infarction (STEMI) treated by Tongxinluo after percutaneous coronary intervention (PCI). Methods: Sixty patients with acute STEMI who underwent emergency PCI were randomly assigned to either the conventional group or the Tongxinluo group. Conventional echocardiography, two-dimensional speckle tracking imaging (2D-STI) and TMAD were performed 72 hours and 12 months after PCI. The following parameters were obtained: left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), stroke output (SV), left ventricular ejection fraction (LVEF-Simpson), global longitudinal strain of left ventricle (GLS), left ventricular global circumferential strain (GCS), septal displacement (TMAD-sep), lateral displacement (TMAD-lat), midpoint displacement (TMAD-midpt) and the percentage of TMAD to LV length from the midpoint of the mitral annulus to the apex at end-diastolic (TMAD-midpt%). And LVEF was measured by three-dimensional automated cardiac function quantification (3DQA) (LVEF-3DQA). Statistical analysis was used to analyze the differences in the above indicators among the groups and their correlations. Results: 12 months after PCI, compared with the conventional group, LVEDD, LVESD and SV decreased, LVEF-Simpson, LVEF-3DQA, GLS, GCS and TMAD parameters increased in the Tongxinluo group (P < 0.05). Correlation analysis showed that TMAD parameters were positively correlated with GLS and LVEF-3DQA, and TMAD-midpt% had the highest correlation with GLS and LVEF-3DQA (r = 0.829，P < 0.01；r = 0.754，P < 0.01), and TMAD-midpt% had good repeatability and good repeatability. Conclusion: TMAD can be used to evaluate the protective effect of Tongxinluo on left ventricular systolic function in patients with acute STEMI after PCI.