TY - JOUR
T1 - Rest global longitudinal 2D strain to detect coronary artery disease in patients undergoing stress echocardiography
T2 - A comparison with wall-motion and coronary flow reserve responses
AU - Gaibazzi, Nicola
AU - Pigazzani, Filippo
AU - Reverberi, Claudio
AU - Porter, Thomas R.
N1 - Publisher Copyright:
© 2014 The authors.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Myocardium subtended by obstructive coronary artery disease (CAD) may show reduced left ventricle (LV) global longitudinal strain (GLS), as well as early systolic lengthening (ESL) before shortening; these can be measured at rest and may predict obstructive CAD. This study investigated whether baseline resting LV longitudinal strain measurements may be able to detect significant CAD in patients undergoing stress echocardiography (SE) and coronary angiography, who have normal resting wall motion. We selected patients with a clinical indication of coronary angiography who were previously referred for SE. Patients with known CAD, rest wall-motion (WM) abnormalities, or rhythm/conduction abnormalities were excluded. Speckle tracking strain analyses were retrospectively performed on digitally archived 2D video-loops, using vendor independent software. Peak GLS and duration of ESL were recorded. Diagnostic accuracy of each parameter to predict obstructive (R50%) CAD was assessed and multivariate logistic regression models fitted and compared. Eighty-two patients were enrolled and 49 had significant CAD by quantitative angiography. Patients with CAD were more often male (PZ0.01) and more frequently presented with typical angina (P<0.01). Among rest and stress variables, GLS showed a Youden index of 0.665, while SEWMassessment showed a Youden index of 0.599. These were the only two parameters that remained predictive in multivariate analyses. In conclusion, rest GLS demonstrated comparable accuracy with stress-echo data for prediction of angiographically obstructive CAD; it also added significant CAD prediction when combined with clinical data, similar to SE WM assessment.
AB - Myocardium subtended by obstructive coronary artery disease (CAD) may show reduced left ventricle (LV) global longitudinal strain (GLS), as well as early systolic lengthening (ESL) before shortening; these can be measured at rest and may predict obstructive CAD. This study investigated whether baseline resting LV longitudinal strain measurements may be able to detect significant CAD in patients undergoing stress echocardiography (SE) and coronary angiography, who have normal resting wall motion. We selected patients with a clinical indication of coronary angiography who were previously referred for SE. Patients with known CAD, rest wall-motion (WM) abnormalities, or rhythm/conduction abnormalities were excluded. Speckle tracking strain analyses were retrospectively performed on digitally archived 2D video-loops, using vendor independent software. Peak GLS and duration of ESL were recorded. Diagnostic accuracy of each parameter to predict obstructive (R50%) CAD was assessed and multivariate logistic regression models fitted and compared. Eighty-two patients were enrolled and 49 had significant CAD by quantitative angiography. Patients with CAD were more often male (PZ0.01) and more frequently presented with typical angina (P<0.01). Among rest and stress variables, GLS showed a Youden index of 0.665, while SEWMassessment showed a Youden index of 0.599. These were the only two parameters that remained predictive in multivariate analyses. In conclusion, rest GLS demonstrated comparable accuracy with stress-echo data for prediction of angiographically obstructive CAD; it also added significant CAD prediction when combined with clinical data, similar to SE WM assessment.
KW - Coronary artery disease
KW - Coronary flow reserve
KW - Global strain
KW - Speckle tracking echocardiography
KW - Stress echocardiography
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U2 - 10.1530/ERP-14-0020
DO - 10.1530/ERP-14-0020
M3 - Article
C2 - 26693302
AN - SCOPUS:85016909182
VL - 1
SP - 61
EP - 70
JO - Echo Research and Practice
JF - Echo Research and Practice
SN - 2055-0464
IS - 2
ER -