The Value of Three‐Dimensional Speckle Tracking Echocardiography in the Estimation of Left Ventricular Systolic Function in Patients With Coronary Microvascular Dysfunction

Purpose This research aims to assess the impact of coronary microvascular dysfunction (CMD) on the systolic function of the left ventricle (LV) in patients with ischemia and no obstructive coronary artery disease (INOCA) by employing three‐dimensional speckle tracking echocardiography (3D‐STE). Methods A group of 66 individuals with INOCA participated in the research. They all went through regadenoson stress echocardiography and measurement of coronary flow velocity reserve (CFVR). Patients were divided into a CMD group with CFVR values less than 2.0 and a control group with CFVR values of 2.0 or higher. Results Compared with controls, the CMD group showed reductions in stress global longitudinal strain (GLS), stress global area strain (GAS), the change in GLS from rest to stress (ΔGLS), and the change in GAS from rest to stress (ΔGAS) (all p < 0.001). All four strain parameters exhibited significant correlations with CFVR. Univariate analysis revealed that stress GLS, stress GAS, ΔGLS, and ΔGAS possessed good predictive value for CMD, among which ΔGAS had higher predictive value, having areas under the curve (AUC) of 0.923. Conclusion Strain parameters derived from 3D‐STE under pharmacologic stress demonstrate excellent benefits in assessing LV systolic function in CMD patients. These parameters, especially ΔGAS, may serve as novel predictive indicators for the clinical assessment of CMD.