Key result
3D global peak longitudinal strain identifies complex NSTE-ACS with high accuracy, showing an AUC of ~0.88.
Why the study?
The performance and diagnostic value of 3-dimensional global peak longitudinal strain (GPLS) in evaluating complex coronary lesions in NSTE-ACS patients had not been carefully studied.
Cross-Sectional (n=59)
Blinded evaluators
No
Effect estimate: AUC 0.882 (95% CI 0.797-0.967)
p-value: p=<0.001
May aid noninvasive detection of complex NSTE-ACS lesions; leaves open validation and impact on management decisions.
The aim of this study is to investigate the value of 3-dimensional global peak longitudinal strain (GPLS) derived from the 3-dimensional speckle-tracking echocardiography (3D-STE) in the diagnosis of the complex non-ST-segment elevation acute coronary syndromes (NSTE-ACS) by comparing GPLS to the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score.A total of 59 inpatients with NSTE-ACS in our hospital between October 2014 and January 2015 were enrolled into our study. All these subjects underwent the coronary angiography (CAG) and 3D-STE examination. The results of CAG were used to calculate the SYNTAX scores in each subject. The GPLS was assessed with speckle-tracking analysis using the dedicated software developed by GE Healthcare (Horten, Norway).We grouped all subjects according to the SYNTAX scores. A total of 23 patients (39%) were grouped as complex NSTE-ACS in our experiment. In our analysis, the values of GPLS significantly decreased from low SYNTAX scores to intermediate or high SYNTAX scores (-14.0 ± 2.7% and -9.5 ± 2.8%, respectively, P < 0.001). Multivariate regression analysis showed that GPLS and diabetes mellitus were independent predictors for complex NSTE-ACS. The area under the receiver operator characteristic curve (AUC) for GPLS to evaluate patients with complex NSTE-ACS was 0.882 (95% confidence interval [CI], 0.797-0.967, P < 0.001) with an optimal cutoff value of -11.76% (sensitivity 82.6% and specificity 83.3%). The evaluative value of the adjusted AUC for evaluating patients with complex NSTE-ACS improved after inclusion of GPLS (C statistics, 0.827-0.948, P < 0.001).The value of GPLS is significantly associated with the complexity of coronary artery lesions, according to SYNTAX score. Therefore, our study indicates that GPLS could be reproducible and efficient to evaluate the complex coronary artery disease in NSTE-ACS patients.
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Cai et al. (2016) conducted a cross-sectional in Non-ST-segment elevation acute coronary syndromes (NSTE-ACS) (n=59). 3-dimensional global peak longitudinal strain (GPLS) vs. Low SYNTAX score (<22) was evaluated on Diagnostic accuracy for identifying complex NSTE-ACS (SYNTAX score ≥22) (AUC 0.882, 95% CI 0.797-0.967, p=<0.001). 3-dimensional global peak longitudinal strain was an independent predictor for complex NSTE-ACS, demonstrating high diagnostic accuracy with an AUC of 0.882 at a cutoff of -11.76%.
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