What question did this study set out to answer?

To determine whether baseline resting left ventricular longitudinal strain measurements can accurately detect significant coronary artery disease in patients with normal resting wall motion undergoing stress echocardiography and coronary angiography.

November 1, 2014Echo Research and PracticeOpen Access

Rest global longitudinal 2D strain to detect coronary artery disease in patients undergoing stress echocardiography: a comparison with wall-motion and coronary flow reserve responses

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Why the study?

Does rest global longitudinal 2D strain accurately detect obstructive coronary artery disease compared to stress echocardiography wall-motion assessment in patients with normal resting wall motion?

Population

82 patients with a clinical indication for coronary angiography previously referred for stress…

Comparison

Rest global longitudinal 2D strain and early… vs Stress echocardiography wall-motion assessment…

Design

Cross-sectional

Authors

NGNicola GaibazziUniversity of Parma FPFilippo PigazzaniUniversity of Dundee CRClaudio ReverberiIstituti Ospitalieri di Cremona

Discussion

Member takes

Implication

Rest GLS may match SE WM accuracy for obstructive CAD detection; leaves open prospective validation before any practice change.

Key Points

To determine whether baseline resting left ventricular longitudinal strain measurements can accurately detect significant coronary artery disease in patients with normal resting wall motion undergoing stress echocardiography and coronary angiography.
Retrospective speckle tracking strain analysis of digitally archived 2D echocardiograms in N=82 patients referred for stress echocardiography and subsequent coronary angiography.
Patients with previously known coronary artery disease, baseline resting wall-motion abnormalities, or rhythm and conduction disorders were excluded.
Peak global longitudinal strain and early systolic lengthening duration were evaluated via multivariate logistic regression for predicting angiographically obstructive (≥50%) coronary artery disease.
Significant coronary artery disease was identified by quantitative angiography in 49 of 82 patients, with higher prevalence among men (P=0.01) and individuals presenting with typical angina (P<0.01).
Resting global longitudinal strain demonstrated a Youden index of 0.665 for identifying obstructive CAD, compared to 0.599 for stress echocardiography wall-motion assessment.
Resting global longitudinal strain and stress wall-motion abnormalities were the only parameters that independently predicted obstructive coronary artery disease in multivariate models.

Structured PICO

Does rest global longitudinal 2D strain accurately detect obstructive coronary artery disease compared to stress echocardiography wall-motion assessment in patients with normal resting wall motion?

Population

82 patients with a clinical indication for coronary angiography previously referred for stress echocardiography, with normal resting wall motion. Excluded: known CAD, rest wall-motion abnormalities, or rhythm/conduction abnormalities.

Intervention

Rest global longitudinal 2D strain (GLS) and early systolic lengthening (ESL) measurement via speckle tracking

Comparator

Stress echocardiography wall-motion (SE WM) assessment and coronary flow reserve responses

Outcome

Diagnostic accuracy to predict obstructive (≥50%) coronary artery disease by quantitative angiographysurrogate

Rest global longitudinal strain offers comparable diagnostic accuracy to stress echocardiography wall-motion assessment for detecting obstructive CAD in patients with normal resting wall motion.

Cite This Study

Gaibazzi et al. (2014) studied this question.

synapsesocial.com/papers/6a894859a4df84145ecafdd8 https://doi.org/10.1530/erp-14-0020

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Rest global longitudinal 2D strain to detect coronary artery disease in patients undergoing stress echocardiography: a comparison with wall-motion and coronary flow reserve responses

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Rest global longitudinal 2D strain to detect coronary artery disease in patients undergoing stress echocardiography: a comparison with wall-motion and coronary flow reserve responses

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider