Key result
Passive LV wall stress models moderately discriminate multivessel CAD with AUCs up to ~0.74.
Why the study?
LV shape is an important index of cardiac pathophysiology, motivating a comparison of Mirsky and Ghista-Sandler ellipsoidal models to estimate wall stress for discriminating significant CAD from no CAD.
Do the Mirsky and Ghista-Sandler ellipsoidal models for estimating left ventricular end-systolic stress accurately discriminate patients with significant multi-vessel CAD from those without?
Cross-Sectional (n=82)
Do the Mirsky and Ghista-Sandler ellipsoidal models for estimating left ventricular end-systolic stress accurately discriminate patients with significant multi-vessel CAD from those without?
Echocardiography-based estimation of left ventricular circumferential end-systolic stress using Mirsky or Ghista-Sandler models provides a noninvasive biomechanical marker to predict multi-vessel coronary artery disease.
May support noninvasive LV stress estimation for multi-vessel CAD detection; hypothesis-generating and requires prospective validation.
Background: The shape of the left ventricle (LV) is an important index to explore cardiac pathophysiology. A comparison was provided to estimate circumferential, longitudinal, and radial wall stress in LV based on the thick-walled ellipsoidal models of Mirsky and Ghista-Sandler for discriminating significant coronary artery disease (CAD) patients from no CAD patients. Materials and Methods: According to the angiography findings, 82 patients with CAD were divided into two groups: 25 patients without significant CAD and 57 patients with significant CAD of single vessel and multivessel. An ellipsoidal LV geometry was used to calculate end-systolic passive stress as the mechanical behavior of LV. Echocardiographic views-based measurements of LV diameters used to estimate the end-systolic wall stress. Results: = 0.005, respectively). All stress parameters of the multi-vessel CAD group were statistically significant compared to the control group for the Mirsky model. Receiver operating characteristics curve analysis was shown the circumferential stress of multi-vessel CAD with an area under the curve (AUC) of 0.736 for the Ghista model and an AUC of 0.742 for the Mirsky model. Conclusion: These results indicated that Ghista and Mirsky model estimates of circumferential passive stress were the potential biomechanical markers to predict patients with multi-vessel CAD. It could be a noninvasive and helpful tool to quantify the contractility of LV.
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Ahmadi et al. (2023) conducted a cross-sectional in Coronary artery disease (n=82). Circumferential passive left ventricular wall stress (Ghista and Mirsky models) vs. No significant coronary artery disease (control group) was evaluated on Discriminatory performance (Area under the ROC curve) of circumferential stress for identifying multi-vessel coronary artery disease (AUC 0.742 for the Ghista model and 0.736 for the Mirsky model). Ghista and Mirsky model estimates of circumferential passive left ventricular wall stress demonstrated diagnostic utility for predicting multi-vessel coronary artery disease with AUCs of 0.742 and 0.736, respectively.
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