Investigation Into the Utility of 3D Speckle‐Tracking Echocardiography in Detecting Coronary Artery Microcirculation Dysfunction in Ischemia With Non‐Obstructive Coronary Artery Disease

Aim To assess the utility of three‐dimensional speckle‐tracking echocardiography (3D‐STE) in detecting coronary artery microcirculation dysfunction (CMCD) with non‐obstructive coronary artery (INOCA) disease. Materials and Methods Twenty‐one patients diagnosed with INOCA were enrolled and underwent echocardiography and [ 18 F]fluorodeoxyglucose positron emission tomography/computed tomography ([ 18 F]FDG PET/CT) myocardial metabolic imaging, which is used as the gold standard for diagnosing CMCD. Further, a total of 357 myocardial segments across these 21 participants were categorized into the control group and the CMCD group according to the results of [ 18 F]FDG PET/CT. Subsequently, 2D regional systolic peak longitudinal strain (2D‐RLS), 2D regional systolic peak circumferential strain (2D‐RCS), regional systolic peak 3D main strain (R3D strain), longitudinal strain (3D‐RLS), circumferential strain (3D‐RCS), and radial strain (3D‐RRS) of the left ventricle were assessed. At last, the receiver operating characteristic (ROC) curves of 3D‐STE parameters were calculated to evaluate the diagnostic value of 3D‐STE for CMCD. Results The absolute value of total R3D strain is decreased in the CMCD group ( p < 0.05). In addition, R3D and 3D‐RLS in the CMCD group exhibited a significant reduction in the basal, middle, and apical segments compared to the control group ( p < 0.05). No difference was observed in 2D strain parameters between the CMCD group and the control group. Among all strain parameters, the R3D strain in the apical segments had the highest diagnostic efficacy, with an optimal cutoff of −41.5 (sensitivity, 88.4%; specificity, 80.5%). Conclusion Our findings indicate that the 3D‐STE could serve as an advantageous diagnostic instrument for discriminating individuals with CMCD.