Speckle tracking echocardiography accurately identified the culprit vessel in NSTE-ACS with 87.3% accuracy, outperforming ECG and TTE significantly (p < 0.05).
Does speckle tracking echocardiography improve the accuracy of identifying the culprit vessel compared to ECG and TTE in patients with NSTE-ACS?
Speckle tracking echocardiography provides superior accuracy compared to ECG and standard TTE for identifying the culprit vessel in NSTE-ACS patients prior to angiography.
Absolute Event Rate: 0% vs 0%
ABSTRACT Purpose This study analyzed the diagnostic efficacy of electrocardiogram (ECG), transthoracic echocardiography (TTE), and speckle tracking echocardiography (STE) in identifying the culprit vessel (CV) in patients with non‐ST‐segment elevation acute coronary syndromes (NSTE‐ACS). It explored the feasibility and accuracy of the noninvasive STE technique in providing clinicians with CV‐related information for treatment decision‐making. Methods One hundred and forty‐two NSTE‐ACS patients were retrospectively analyzed to evaluate the diagnostic efficacy of ECG, wall motion score index (WMSI) of TTE, and territorial longitudinal strain (TLS) of STE in identifying the CV before coronary angiography (CAG). Results STE demonstrated superior accuracy (87.3%, p < 0.05) for CVs identification versus ECG (23.2%) and TTE (47.9%). The sensitivities of ECG, TTE, and STE in identifying the left anterior descending artery as the CV were 35.7%, 58.9%, and 89.3%, respectively ( p < 0.05), with specificities of 88.4%, 90.7%, and 95.3%. For the right coronary artery, sensitivities were 17.5%, 35.0%, and 75.0% ( p < 0.05; specificities: 93.1%, 92.1%, and 98.0%). For the left circumflex artery, sensitivities were 13.0%, 52.2%, and 95.7% ( p < 0.05; specificities: 96.9%, 88.5%, and 87.5%). The WMSI + TLS model outperformed WMSI alone ( p < 0.001). In multivessel disease, epicardial TLS (Epi ‐ TLS) independently predicted the CV ( p < 0.001) and surpassed other myocardial layers in diagnostic performance. Conclusion This study demonstrated that STE showed superior accuracy to other noninvasive techniques in the identification of CV in NSTE‐ACS patients before CAG. Epi‐TLS offered unique value in discriminating the true CV among multivessel disease. STE offered practical bedside evaluation for NSTE‐ACS patients before invasive procedures. Trial Registration Dalian Friendship Municipal Hospital, China: CTR2500108952
Sun et al. (Thu,) reported a other. Speckle tracking echocardiography accurately identified the culprit vessel in NSTE-ACS with 87.3% accuracy, outperforming ECG and TTE significantly (p < 0.05).