Key result
Global longitudinal strain obtained by two-dimensional strain echocardiography was a significant independent predictor of true positive coronary artery disease (OR 0.25), offering sensitivity and specificity similar to myocardial perfusion scintigraphy.
Why the study?
Myocardial perfusion scintigraphy accuracy can be affected by artifacts, prompting a comparison with global longitudinal strain from strain echocardiography in stable angina pectoris patients.
Does global longitudinal strain by echocardiography provide similar diagnostic accuracy to myocardial perfusion scintigraphy for detecting coronary artery disease in patients with stable angina?
Observational (n=133)
No
Does global longitudinal strain by echocardiography provide similar diagnostic accuracy to myocardial perfusion scintigraphy for detecting coronary artery disease in patients with stable angina?
Odds Ratio: 0.25 (95% CI 0.08–0.73)
p-value: p=0.012
Global longitudinal strain by 2D echocardiography offers similar sensitivity and specificity to myocardial perfusion scintigraphy for detecting coronary artery disease in stable angina patients.
OBJECTIVE: Myocardial perfusion scintigraphy is a common non-invasive method for assessing ischemic burden, though artifacts can affect accuracy. Speckle-tracking strain echocardiography improves left ventricular function assessment, and global longitudinal strain correlates well with coronary artery disease. The aim of this study was to compare myocardial perfusion scintigraphy with global longitudinal strain in stable angina pectoris patients. METHODS: A total of 133 suspected coronary artery disease patients who underwent myocardial perfusion scintigraphy and coronary angiography were prospectively enrolled and classified as myocardial perfusion scintigraphy true positives or false positives based on coronary angiography results. Global longitudinal strain values for the epicardium, endocardium, and myocardium (avg) were calculated. RESULTS: Ischemic percentages of myocardial perfusion scintigraphy>12% and mid-wall global longitudinal strain<-18.4% correlated with true positive coronary angiography results. Left ventricular ejection fraction/global longitudinal strain mid ratio positively correlated with coronary artery disease presence and severity. Higher ischemic percentages of myocardial perfusion scintigraphy showed a negative correlation (r: -0.2606, p: 0.002) with global longitudinal strain, indicating a greater likelihood of coronary artery disease (OR 0.25, 95%CI 0.08-0.73, p: 0.012). Female sex was linked to fewer true positive myocardial perfusion scintigraphy results. CONCLUSION: The GLS value of the Left Ventricle obtained by two-dimentional strain echocardiography offers sensitivity and specificity similar to myocardial perfusion scintigraphy in the detection of coronary artery disease.. An elevated left ventricular ejection fraction/global longitudinal strain ratio is a significant predictor of the presence and severity of coronary artery disease.
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Kaya et al. (2025) conducted an observational in Suspected coronary artery disease (n=133). Global longitudinal strain (GLS) via strain echocardiography vs. Myocardial perfusion scintigraphy (MPS) was evaluated on Presence of true positive coronary artery disease confirmed by coronary angiography (OR 0.25, 95% CI 0.08-0.73, p=0.012). Global longitudinal strain obtained by two-dimensional strain echocardiography was a significant independent predictor of true positive coronary artery disease (OR 0.25), offering sensitivity and specificity similar to myocardial perfusion scintigraphy.
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