Key result
Transient acute coronary occlusion linked to ~25% lower Myocardial Work Index vs. baseline.
Why the study?
Strain parameters are load dependent, and the ability of non-invasive myocardial work indices to identify the ischaemic risk area during transient acute coronary occlusion required investigation.
Does transient acute coronary occlusion acutely impair non-invasive myocardial work parameters in patients with critical coronary stenosis?
Observational (n=50)
No
Does transient acute coronary occlusion acutely impair non-invasive myocardial work parameters in patients with critical coronary stenosis?
Absolute Event Rate: 1387% vs 1843%
p-value: p=<0.001
Non-invasive myocardial work parameters are highly sensitive early markers of myocardial ischemia that significantly decline during brief transient coronary occlusion.
May support myocardial work as sensitive ischemia marker in critical stenosis; hypothesis-generating and should not yet change practice.
Background During ischemia a close relationship exists between sub-endocardial blood flow and myocardial function. Strain parameters can capture an impairment of regional longitudinal function but are load dependent. Recently, a novel non-invasive method to calculate Myocardial Work (MW) showed a strong correlation with invasive work measurements. Our aim was to investigate the ability of non-invasive MW indices to identify the ischaemic risk area during transient acute coronary occlusion (TACO). Methods and results The study population comprises 50 individuals with critical coronary stenosis (CCS). Echocardiography recordings were obtained before coronary angiography, during TACO and after revascularization to measure global longitudinal strain (GLS), Myocardial Work Index (MWI), Myocardial Constructive Work (MCW), Myocardial Wasted work (MWW), Myocardial work efficiency (MWE). Compared to baseline, we found a significant reduction of GLS (p = 0.005), MWI, MCW and MWE (p<0.001) during TACO. Conclusions The non-invasive measurement of MW parameters is a sensitive and early marker of myocardial ischemia during TACO.
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Sabatino et al. (2020) conducted an observational in Critical coronary stenosis (n=50). Transient acute coronary occlusion (TACO) vs. Baseline (before coronary angiography) was evaluated on Myocardial Work Index (MWI) (p=<0.001). Transient acute coronary occlusion significantly reduced Myocardial Work Index from 1843 to 1387 mmHg% (p<0.001) and impaired global longitudinal strain compared to baseline.
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