Key result
Speckle-tracking echocardiography detects significant CAD in NSTE-ACS cases lacking ECG changes or elevated cardiac enzymes.
Why the study?
The potential of speckle-tracking echocardiography with LV myocardial work assessment was evaluated for diagnosing non-ST-segment elevation acute coronary syndrome in patients presenting without ECG changes, hyperenzymemia, or visual contractility abnormalities on standard echocardiography.
Does speckle-tracking echocardiography with assessment of left ventricular longitudinal strain and myocardial work parameters predict significant coronary artery disease in patients with non-ST-segment elevation acute coronary syndrome without ECG changes or hyperenzymemia?
Case Report (n=2)
Does speckle-tracking echocardiography with assessment of left ventricular longitudinal strain and myocardial work parameters predict significant coronary artery disease in patients with non-ST-segment elevation acute coronary syndrome without ECG changes or hyperenzymemia?
Speckle-tracking echocardiography assessing left ventricular longitudinal strain and myocardial work parameters may help identify significant coronary artery disease and guide invasive angiography in NSTE-ACS patients presenting without ECG changes, elevated cardiac enzymes, or visual wall motion abnormalities.
Should not yet guide angiography decisions in NSTE-ACS; leaves open the utility of speckle-tracking parameters in this population.
The paper presents case reports of two patients hospitalized with non-ST-segment elevation acute coronary syndrome, atypical pain syndromes, without ECG signs of ischemia, and who showed no hyperenzymemia or visual contractility abnormalities on a standard echocardiography. In both cases, speckle tracking echocardiography was performed upon admission to measure left ventricular (LV) global and regional longitudinal strain and myocardial work parameters. Changes in myocardial function, identified during assessment of LV longitudinal strain and myocardial work parameters allowed to predict a significant coronary artery disease and to determine indications for invasive coronary angiography and myocardial revascularization.
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Tyurina et al. (2026) conducted a case report in Non-ST-segment elevation acute coronary syndrome without ECG changes (n=2). Speckle-tracking echocardiography assessing LV longitudinal strain and myocardial work parameters vs. Standard echocardiography was evaluated on Prediction of significant coronary artery disease and determination of indications for invasive coronary angiography and myocardial revascularization. Speckle-tracking echocardiography assessing LV strain and myocardial work predicted significant CAD in 2 of 2 (100%) NSTE-ACS patients without ECG changes or elevated enzymes.
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