Key result
Regional peak systolic strain by 2D STE correlated significantly with coronary angiogram findings in patients with stable angina (P=0.03), but not in those with acute coronary syndrome (P=0.136).
Why the study?
Although 2D STE assesses LV function via GLS, it is not incorporated into daily practice despite evidence supporting its diagnostic value for detecting significant CAD and predicting culprit arteries.
Does 2D speckle-tracking echocardiography correlate with coronary angiography in predicting significant coronary artery disease and localizing the culprit vessel in symptomatic patients?
Observational (n=79)
No
Does 2D speckle-tracking echocardiography correlate with coronary angiography in predicting significant coronary artery disease and localizing the culprit vessel in symptomatic patients?
p-value: p=0.03
2D speckle-tracking echocardiography is a useful noninvasive tool for localizing culprit vessels in chronic coronary syndrome, particularly in patients with adequate left ventricular systolic function.
GLS by 2D STE may aid CAD detection; leaves open need for prospective validation before routine use.
Background: Two-dimensional speckle-tracking echocardiography (2D STE) has been used by many cardiologists globally for assessing the left ventricle (LV) function by having global longitudinal strain (GLS) as an important parameter; however, it is not incorporated into daily practice and some studies have proved to be a better diagnostic value for evaluation of detecting significant coronary artery disease (CAD) and also in predicting the culprit coronary artery. Methods: We enrolled 100 consecutive symptomatic patients with suspected CAD who have undergone angiogram in our institute. Out of these, 21 patients had poor echo window and were excluded. The patients were divided into two groups those presenting with acute coronary syndrome ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), and others with stable angina. All patients underwent a 2D echocardiogram, 2D strain imaging, and coronary angiogram. Results: GLS correlated well with ejection fraction in our study. GLS was more impaired in patients with double- and triple-vessel disease than in patients with single-vessel disease. The number of patients presented with STEMI is 26 (anterior wall myocardial infarction – 20 and inferior wall myocardial infarction – 6), 23 had NSTEMI, and 30 had stable angina. The results of regional peak systolic strain had a stronger correlation with coronary angiogram in stable angina ( P = 0.03), but in ACS patients, it was not significant ( P = 0.136). This correlation was better in patients with adequate LV systolic function ( P < 0.05) than patients with left ventricular systolic dysfunction ( P = 1.0). Conclusion: 2D STE is a simple, noninvasive, and reproducible diagnostic tool in the evaluation of CAD and is immensely helpful in the localization of culprit vessel in chronic coronary syndrome.
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Sankaran et al. (2022) conducted an observational in Coronary artery disease (n=79). Two-dimensional speckle-tracking echocardiography (2D STE) vs. Coronary angiogram was evaluated on Correlation of regional peak systolic strain with coronary angiogram (p=0.03). Regional peak systolic strain by 2D STE correlated significantly with coronary angiogram findings in patients with stable angina (P=0.03), but not in those with acute coronary syndrome (P=0.136).
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