David E Montgomery1, Jyothy J Puthumana, Justin M Fox, Kofo O Ogunyankin. 1. Division of Cardiology, Department of Medicine, Feinberg School of Medicine, The Bluhm Cardiovascular Institute, Northwestern University, 626 N. St. Clair Street Suite 600, Chicago, IL 60611, USA.
Abstract
AIMS: To evaluate the diagnostic power of abnormal global longitudinal strain (GLS) to detect non-obstructive coronary artery disease (CAD) in the resting echocardiogram. GLS using two-dimensional speckle-tracking echocardiography (2D STE) is a powerful tool for detecting advanced CAD. However, the diagnostic power of 2D STE for detecting moderate, clinically unapparent CAD from images obtained at rest is unknown. METHODS AND RESULTS: We retrospectively studied 2D STE characteristics in 123 consecutive patients who underwent stress echocardiography, and subsequently coronary angiography within 10 days. We compared the diagnostic power of GLS at rest to the conventional wall motion score index (WMSI) during stress for detecting stenosis ≥ 50% (CAD(>50)) in any major coronary artery. Studies with akinetic or dyskinetic segments and reduced left ventricular ejection fraction were excluded. In 56 patients with significant CAD(>50), GLS was -16.77 ± 3.18% compared with -19.05 ± 3.43% in the 67 patients without CAD(<50) (P = 0.0002). A GLS cutpoint of greater than -17.77% had the most optimal sensitivity and specificity (66/76%) for detecting CAD and was comparable to a WMSI ≥ 1.13 (68/70%) measured during stress. CONCLUSION: Non-obstructive CAD was identified by a reduced GLS measured by 2D STE in rest images with similar accuracy to the traditional WMSI measured in stress echocardiography.
AIMS: To evaluate the diagnostic power of abnormal global longitudinal strain (GLS) to detect non-obstructive coronary artery disease (CAD) in the resting echocardiogram. GLS using two-dimensional speckle-tracking echocardiography (2D STE) is a powerful tool for detecting advanced CAD. However, the diagnostic power of 2D STE for detecting moderate, clinically unapparent CAD from images obtained at rest is unknown. METHODS AND RESULTS: We retrospectively studied 2D STE characteristics in 123 consecutive patients who underwent stress echocardiography, and subsequently coronary angiography within 10 days. We compared the diagnostic power of GLS at rest to the conventional wall motion score index (WMSI) during stress for detecting stenosis ≥ 50% (CAD(>50)) in any major coronary artery. Studies with akinetic or dyskinetic segments and reduced left ventricular ejection fraction were excluded. In 56 patients with significant CAD(>50), GLS was -16.77 ± 3.18% compared with -19.05 ± 3.43% in the 67 patients without CAD(<50) (P = 0.0002). A GLS cutpoint of greater than -17.77% had the most optimal sensitivity and specificity (66/76%) for detecting CAD and was comparable to a WMSI ≥ 1.13 (68/70%) measured during stress. CONCLUSION: Non-obstructive CAD was identified by a reduced GLS measured by 2D STE in rest images with similar accuracy to the traditional WMSI measured in stress echocardiography.
Authors: Christoffer A Hagemann; Søren Hoffmann; Rikke A Hagemann; Thomas Fritz-Hansen; Flemming J Olsen; Peter G Jørgensen; Tor Biering-Sørensen Journal: Int J Cardiovasc Imaging Date: 2019-06-21 Impact factor: 2.357
Authors: Jiwon Kim; Sara Rodriguez-Diego; Aparna Srinivasan; Rachel-Maria Brown; Meridith P Pollie; Antonino Di Franco; Samantha R Goldburg; Jonathan Y Siden; Mark B Ratcliffe; Robert A Levine; Richard B Devereux; Jonathan W Weinsaft Journal: Echocardiography Date: 2017-08-22 Impact factor: 1.724
Authors: Jian Chen; Juan Lei; Ernest Scalzetti; Mary McGrath; David Feiglin; Robert Voelker; Jingfeng Wang; Michael C Iannuzzi; Kan Liu Journal: Int J Cardiovasc Imaging Date: 2017-09-09 Impact factor: 2.357