Why the study?
Optimal non-invasive stress testing and revascularization decisions remain debated in chronic coronary syndrome, warranting evaluation of resting and post-isometric loading speckle-tracking GLS compared to FFR.
Does dynamic global longitudinal strain after isometric hand-grip exercise predict functionally significant coronary lesions compared to FFR in patients with chronic coronary syndrome?
Does dynamic global longitudinal strain after isometric hand-grip exercise predict functionally significant coronary lesions compared to FFR in patients with chronic coronary syndrome?
Dynamic GLS during isometric hand-grip exercise demonstrates high diagnostic accuracy for identifying functionally significant coronary lesions.
May support noninvasive lesion detection in chronic coronary syndrome; hypothesis-generating from Level 4 data and requires prospective validation.
Aims: There is still a wide debate regarding the management of patients with chronic coronary syndrome, the choice of optimal non-invasive stress test, and the decision for coronary revascularization. Evidence has accumulated demonstrating the utility of global longitudinal strain (GLS) as a predictor of significant coronary disease. To evaluate the application of speckle tracking during resting echocardiography and after isometric loading with the hand-grip test, and to compare GLS parameters with fractional flow reserve (FFR). Methods and results: < 0.001. ΔGLS of 0.35 showed good diagnostic performance capacity (AUC 0.896, 95% CI: 0.83-0.96, specificity 85%, sensitivity 92%) for a functionally significant coronary lesion. Conclusion: Dynamic GLS during isometric hand-grip exercise is a feasible method for functional assessment in patients with chronic coronary syndrome.
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Mileva et al. (2026) studied this question.
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