Key result
Global longitudinal peak systolic strain by speckle tracking echocardiography accurately diagnosed single vessel coronary artery disease (90% sensitivity, 95.1% specificity, AUC 0.954).
Why the study?
Does speckle tracking echocardiography accurately detect the presence and severity of coronary artery disease compared to coronary angiography in patients with suspected stable angina pectoris and normal resting conventional echocardiography?
Observational (n=200)
Does speckle tracking echocardiography accurately detect the presence and severity of coronary artery disease compared to coronary angiography in patients with suspected stable angina pectoris and normal resting conventional echocardiography?
Effect estimate: AUC 0.954
Two-dimensional speckle tracking echocardiography provides good sensitivity and specificity for predicting the presence, extent, and severity of CAD in patients with suspected stable angina and normal resting conventional echocardiography.
May aid noninvasive CAD detection in stable angina; leaves open its integration into diagnostic algorithms without randomized validation.
BACKGROUND: To examine the value of speckle tracking echocardiography to detect the presence, extent and severity of coronary artery affection in patients with suspected stable angina pectoris. METHODS: Two hundred candidates with suspected stable angina pectoris and normal resting conventional echocardiography were subjected to speckle tracking echocardiography and coronary angiography. Global and segmental longitudinal peak systolic strain were assessed and were correlated to the results of coronary angiography for each patient. RESULTS: There was a statistically significant difference in the mean of global longitudinal peak systolic strain between normal coronaries and different degrees of coronary artery disease (CAD) (-20.11±0.8 for normal, -18.34±2.52 for single vessel, -16.14±2.85 for two vessels, -14.81±2.12 for three vessels, -13.01±2.92 for left main disease). GLPSS showed high sensitivity for the diagnosis of single vessel CAD (90%, specificity 95.1%, cutoff value: -18.44, AUC: 0.954); two vessels disease (90%, sensitivity 88.9%, cutoff value -17.35, AUC: 0.906) and for three vessels CAD (cutoff value -15.33, sensitivity 63% and specificity 72.2% AUC 0.681) segmental LPSS also showed statistical significance for localization of the affected vessel for left anterior descending, left circumflex and right coronary artery (ρ=0.001) and inverse correlation with syntax score that was significant with high and intermediate score (ρ=0.001) and insignificant for low syntax score (ρ value 0.05). CONCLUSION: Two-dimensional speckle tracking echocardiography has good sensitivity and specificity to predict the presence, extent and severity of CAD.
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Moustafa et al. (2017) conducted an observational in suspected stable angina pectoris (n=200). Speckle tracking echocardiography vs. Coronary angiography was evaluated on Diagnosis of single vessel coronary artery disease (AUC 0.954). Global longitudinal peak systolic strain by speckle tracking echocardiography accurately diagnosed single vessel coronary artery disease (90% sensitivity, 95.1% specificity, AUC 0.954).
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