Key result
Ghista-Sandler wall stress model outperforms Mirsky model in diagnosing moderate to severe coronary artery stenosis.
Why the study?
Coronary artery stenosis alters myocardial mechanics, prompting a comparison of the Ghista-Sandler and Mirsky models for noninvasive wall stress evaluation and discriminant analysis.
Does the Ghista-Sandler model improve specificity and sensitivity in diagnosing coronary stenosis compared to the Mirsky model in CAD patients?
Observational (n=59)
Does the Ghista-Sandler model improve specificity and sensitivity in diagnosing coronary stenosis compared to the Mirsky model in CAD patients?
The Ghista-Sandler model demonstrates better diagnostic performance (higher sensitivity and specificity) than the Mirsky model for noninvasive evaluation of myocardial wall stress in patients with coronary stenosis.
May support Ghista-Sandler model for noninvasive CAD assessment; hypothesis-generating and requires prospective validation before practice change.
Coronary artery stenosis is the most common heart disease, leading to altered myocardial mechanics. This study aimed to compare Ghista–Sandler and Mirsky wall stress models and evaluate the discriminant analysis of noninvasive wall stress based on these models. 59 Coronary artery disease (CAD) patients were divided into two groups; moderate stenosis and severe stenosis in the left anterior descending artery proximal part were enrolled in this study. The wall stress in the end-systolic and end-diastolic phases at LV anterior and interventricular septum wall segments calculated by using the equation proposed by Ghista–Sandler and Mirsky. The specificity and sensitivity of wall stress at groups were calculated by Ghista–Sandler and Mirsky models. The wall thickness and principal radius of segments in healthy subjects and patients with severe and moderate stenosis were shown statistically differences in some segments of anterior and septum walls ([Formula: see text]). Statistical analysis showed that calculated stresses in myocardial wall segments of patients with severe and moderate coronary stenosis and healthy people had a significant difference in systole and diastolic phase. Results of the discriminant analysis showed the specificity value obtained by the Ghista–Sandler model were higher in most wall stress combinations than the Mirsky model. Sensitivity in identifying patients with severe stenosis was higher in the Ghista–Sandler model. It is concluded that specificity and sensitivity based on wall stresses calculated by the Ghista–Sandler model were higher in comparison with the Mirsky model. The Ghista–Sandler model has better performance than the Mirsky model in diagnosing patients with stenosis.
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Khosravanipour et al. (2021) conducted an observational in Coronary artery disease (CAD) (n=59). Ghista-Sandler wall stress model vs. Mirsky wall stress model was evaluated on Specificity and sensitivity of wall stress in diagnosing stenosis. The Ghista-Sandler wall stress model yielded higher specificity and sensitivity compared to the Mirsky model for diagnosing patients with moderate to severe coronary artery stenosis.
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