Key result
Global longitudinal strain detects significant CAD with ~83% sensitivity.
Why the study?
The study was designed to assess whether longitudinal 2D strain analysis using speckle tracking echocardiography can predict the presence of coronary artery disease in patients presenting without regional wall motion abnormalities at rest.
Does longitudinal 2D strain analysis using speckle tracking echocardiography detect significant coronary artery disease in patients with suspected CAD and no regional wall motion abnormality at rest?
Cross-Sectional (n=66)
No
Does longitudinal 2D strain analysis using speckle tracking echocardiography detect significant coronary artery disease in patients with suspected CAD and no regional wall motion abnormality at rest?
Effect estimate: AUC 0.877 (95% CI 0.749-0.960)
p-value: p=<0.001
Global peak systolic longitudinal strain using speckle tracking echocardiography at rest is a sensitive and specific non-invasive tool for detecting significant CAD in patients without regional wall motion abnormalities.
May support GLS for CAD detection without wall motion abnormalities; leaves open prospective validation before clinical adoption.
Background: Speckle-tracking imaging is a novel method for assessing left ventricular (LV) function and ischemic changes. The aim of this study was to predict the presence of coronary artery disease by longitudinal 2D strain analysis using speckle tracking echocardiography in patients with stable or unstable angina with no regional wall motion abnormality at rest. Objectives: Objective of this study is to predict the presence of significant CAD in a patient with no regional wall motion abnormality by longitudinal 2D strain analysis using speckle tracking echocardiography. Methods: This cross-sectional study included a total 66 patients (mean age, 51.92±8.9 years) with suspected CAD without RWMA on resting echocardiography who underwent coronary angiography. Longitudinal 2D strain analysis by STE was performed in all patients before coronary angiography. Global and segmental peak systolic longitudinal strain (PSLS) were recorded & computed by offline dedicated software semi-automatically on bull’s-eye report. The patients were divided into two groups according to the coronary angiographic findings; group- I: significant CAD on coronary angiogram (n=35), group-II: normal coronaries on CAG (n=31).All the baseline characteristics and outcome were then compared between the two groups. Results: PSLSs of all left ventricular segments were obtained successfully in 66 patients. PSLS (both global and segmental) was significantly decreased in patients with significant CAD on CAG group. Receiver operating characteristic (ROC) curve analysis demonstrated that global PSLSs could effectively detect patients with CAD (area under ROC curve = 0.877, 95% CI=0.749–0.960). According to ROC curve analysis, -18.77% appeared to be a good cutoff value for predicting those with significant CAD (specificity 77.4% and sensitivity 82.9%). Conclusion: Global and segmental PSLS using speckle tracking echocardiography at rest was significantly lower in patients with CAD without RWMA, and might be useful for identifying patients with a significant CAD with good degree of sensitivity and specificity.
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Shahriar et al. (2022) conducted a cross-sectional in Suspected coronary artery disease with no regional wall motion abnormality at rest (n=66). Global peak systolic longitudinal strain (PSLS) using speckle tracking echocardiography vs. Normal coronaries or no significant CAD on coronary angiogram was evaluated on Detection of significant coronary artery disease (AUC 0.877, 95% CI 0.749-0.960, p=<0.001). Global peak systolic longitudinal strain using speckle tracking echocardiography effectively detected significant coronary artery disease with an AUC of 0.877, sensitivity of 82.9%, and specificity of 77.4% at a cutoff of -18.77%.
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