Key result
Elevated 16R-SDI on 3D echo identifies severe CAD with ~93% specificity despite normal wall motion.
Why the study?
To investigate left ventricular dyssynchrony using 3-DE in CAD patients without regional wall-motion abnormalities and explore its relationship with CAD severity assessed by the Gensini score.
Does left ventricular dyssynchrony assessed by three-dimensional echocardiography correlate with coronary artery disease severity in patients without regional wall-motion abnormality?
Observational (n=61)
Does left ventricular dyssynchrony assessed by three-dimensional echocardiography correlate with coronary artery disease severity in patients without regional wall-motion abnormality?
Three-dimensional echocardiography can detect left ventricular dyssynchrony in CAD patients without regional wall-motion abnormalities, and the 16R-SDI parameter correlates significantly with angiographic CAD severity.
May support 3D echo dyssynchrony assessment for CAD severity without wall-motion abnormalities; hypothesis-generating and requires prospective validation before clinical use.
OBJECTIVES: Our study investigated left ventricular dyssynchrony (LVD) in coronary artery disease (CAD) patients without regional wall-motion abnormality (RWMA) by three-dimensional echocardiography (3-DE) and explored the relationship between LVD and severity of CAD as assessed by the Gensini score (GS). METHODS: Sixty-one patients with a confirmed diagnosis of CAD by coronary angiography (CAG) were enrolled. We quantified LVD parameters, including the left ventricular segments (16, 12, and 6) standard deviation of the time to minimum systolic volume (TmsvSD-16, TmsvSD-12, and TmsvSD-6) and the systolic dyssynchrony index in regions 16, 12, and 6 (16R-SDI, 12R-SDI, 6R-SDI) using 3-DE. The severity of coronary atherosclerotic lesions was evaluated by the GS system on the basis of CAG findings. We further divided all patients into three groups according to the tertiles of GS: low-GS ≤20, mid-GS >20 and ≤48, and high-GS >48. The differences of LVD values among the three groups were compared, and the associations between LVD parameters and GS were analyzed. RESULTS: Coronary artery disease patients demonstrated increased LVD parameters compared with healthy controls. TmsvSD12, 16R-SDI, and 6R-SDI were prolonged in the high-GS group compared with the low- and mid-GS groups. 16R-SDI was positively correlated with the GS, and multivariate regression analysis showed that 16R-SDI was an independent predictor of the GS. 16R-SDI above 10.7% had a sensitivity of 84.21% and a specificity of 92.86% for identifying high-GS. CONCLUSION: Three-dimensional echocardiography is a noninvasive technique to detect LVD in non-RWMA CAD patients, and the parameter 16R-SDI was significantly correlated with CAD severity.
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Li et al. (2019) conducted an observational in Coronary artery disease without regional wall-motion abnormality (n=61). Left ventricular dyssynchrony assessed by three-dimensional echocardiography vs. Healthy controls and lower Gensini score groups was evaluated on Severity of coronary artery disease as assessed by the Gensini score. In CAD patients without regional wall-motion abnormality, a 16R-SDI above 10.7% assessed by 3D echocardiography identified a high Gensini score with 84.21% sensitivity and 92.86% specificity.
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