Why the study?
The study was conducted to determine the diagnostic accuracy of two-dimensional speckle tracking echocardiography in detecting significant CAD in patients undergoing resting or stress echocardiography.
Does two-dimensional speckle tracking echocardiography accurately detect obstructive coronary artery disease in patients with suspected CAD?
Does two-dimensional speckle tracking echocardiography accurately detect obstructive coronary artery disease in patients with suspected CAD?
Two-dimensional speckle tracking echocardiography demonstrates high sensitivity and specificity for detecting obstructive coronary artery disease during both resting and stress echocardiography.
STE may aid noninvasive CAD detection at rest or stress; leaves open need for standardized thresholds and prospective validation.
Background: Two-dimensional speckle tracking echocardiography (STE) is a quantitative myocardial strain imaging technique in evaluating global and segmental myocardial deformation. The aim of the meta-analysis was to determine the diagnostic accuracy of STE in the detection of significant coronary artery disease (CAD) in patients undergoing resting or stress echocardiography. Methods: We performed a literature search in PubMed and Medline until March 2020 for studies evaluating the role of STE in diagnosing CAD. We assessed the diagnostic performance of STE in detecting CAD by using the pooled estimate of sensitivity, specificity, likelihood ratio, diagnostic odds ratio and diagnostic accuracy. We analyzed longitudinal strain data that were reported in resting and stress echocardiography. Results: A total of 17 studies (n=1762) were included for the analysis. 12 studies (n=1239) reported global longitudinal strain (GLS) in resting echocardiography and 5 studies (n=523) reported GLS in stress echocardiography. Overall, in resting echocardiography studies, pooled GLS sensitivity and specificity for predicting obstructive CAD data were calculated to be 79% (95% confidence interval 74-83%) and 77% (95% confidence interval 72-82%), respectively. The pooled odds ratio was 13.6 (95% confidence interval 8.7-21.5). When we considered the dobutamine stress echocardiograms alone, the sensitivity and specificity in predicting obstructive CAD was 77% (95% confidence interval 59-89%) and 78% (95% confidence interval 53-92%), respectively. The odds ratio was 12.6 (95% confidence interval 2.7-58.5). Conclusions: In this meta-analysis of patients with suspected CAD, we found that STE could effectively detect obstructive CAD with a high diagnostic sensitivity, specificity and diagnostic accuracy
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Kannan et al. (2021) studied this question.
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