Key result
CCTA-derived segmental radial strain was significantly lower in abnormal myocardial segments compared to normal segments (14.81% vs 17.17%, p<0.001) in CAD patients with preserved LVEF.
Why the study?
To evaluate the feasibility of using CCTA-derived strain to detect regional myocardial dysfunction in CAD patients with normal LVEF.
Does CCTA-derived strain analysis detect regional myocardial dysfunction in CAD patients with preserved LVEF?
Observational (n=101)
Does CCTA-derived strain analysis detect regional myocardial dysfunction in CAD patients with preserved LVEF?
Absolute Event Rate: 14.81% vs 17.17%
p-value: p=< 0.001
CCTA-derived strain parameters can feasibly detect regional myocardial dysfunction and distinguish between normal, ischemic, and infarcted myocardium in CAD patients with preserved LVEF.
CCTA strain may detect regional dysfunction in preserved-LVEF CAD; hypothesis-generating and requires prospective validation.
OBJECTIVES: To evaluate the feasibility of using coronary computed tomography angiography (CCTA)-derived strain to detect regional myocardial dysfunction in coronary artery disease (CAD) patients with normal left ventricular ejection fraction (LVEF). METHODS: A total of 1,580 segments from 101 patients who underwent stressed CT myocardial perfusion imaging (CT-MPI) and CCTA were retrospectively enrolled in this study. The CT-derived global and segmental strain values were evaluated using the feature tracking technique. Segments with myocardial blood flow (MBF) < 125 ml/min/100 ml and 95 ml/min/100 ml were categorized as ischemic and infarcted, respectively. RESULTS: Segmental radial strain (SRS) and segmental circumferential strain (SCS) in the abnormal segments (including all segments with MBF < 125 ml/min/100 ml) were significantly lower than those in the normal segments (14.81±8.65% vs 17.17±9.13%, p < 0.001; -10.21±5.79% vs -11.86±4.52%, p < 0.001, respectively). SRS and SCS values in infarcted segments were significantly impaired compared with the ischemic segments (12.43±8.03% vs. 15.32±8.71%, p = 0.038; -7.72±5.91% vs. -10.67±5.66%, p = 0.010, respectively). The AUCs for SRS and SCS in detecting infarcted segments were 0.622 and 0.698, respectively (p < 0.05). CONCLUSIONS: It is feasible for using CCTA-derived strain parameters to detect regional myocardial dysfunction in CAD patients with preserved LVEF. Segmental radial and circumferential strain have the potential ability to distinguish myocardial ischemia from infarction, and normal from ischemic myocardium.
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Zhu et al. (2022) conducted an observational in Coronary artery disease with preserved left ventricular ejection fraction (n=101). CCTA-derived strain analysis vs. Normal myocardial segments was evaluated on Segmental radial strain in abnormal segments (MBF < 125 ml/min/100 ml) vs normal segments (p=< 0.001). CCTA-derived segmental radial strain was significantly lower in abnormal myocardial segments compared to normal segments (14.81% vs 17.17%, p<0.001) in CAD patients with preserved LVEF.
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