scholarly journals Role of territorial speckle tracking echocardiography in identifying the localization of significant coronary artery disease in patients with non-ST-segment elevation acute coronary syndromes

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Gherbesi ◽  
G Chiarello ◽  
V L Paiocchi ◽  
L A Leo ◽  
S A Schlossbauer ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Wall Motion ◽  
Speckle Tracking Echocardiography ◽  
St Segment Elevation ◽  
Non Invasive ◽  
St Segment ◽  
Coronary Syndromes ◽  
Wall Motion Abnormalities ◽  
Artery Disease

Abstract Background In non-ST-segment elevation acute coronary syndromes (NSTE-ACS) patients, several studies demonstrated that 2D speckle tracking echocardiography (STE) is able to predict the presence of coronary artery disease (CAD). Conversely, the role of STE for the localization of significant CAD is less well established. Purpose To investigate the role of territorial longitudinal (TLS) and circumferential strain (TCS) assessed with STE as a non-invasive predictor of localization of significant CAD in patients with NSTE-ACS. Methods We retrospectively enrolled NSTE-ACS patients with significant stenosis (≥70%) at least in one major epicardial coronary artery and without previous cardiovascular events over two years of time. Echocardiography was recorded before coronary angiography and myocardial strain was evaluated offline by an operator blinded to clinical data. Territorial strain was calculated grouping and averaging the strain values of the segments perfused by the 3 major coronary arteries. Results 150 patients were included (age 66.3±11.8 years, 71% male; 90.7% NSTEMI and 9.3% unstable angina). ROC curve analysis demonstrated the ability of TLS and TCS to identify the presence of coronary stenosis of LAD, LCX or RCA (AUC for TLS-LAD 0.74 [0.66–0.82] p=0.0001; LCX 0.73 [0.65–0.81] p=0.0001; RCA 0.69 [0.60–0.77] p=0.0001-AUC for TCS-LAD 0.80 [0.70–0.90] p=0.0001; LCX 0.76 [0.67–0.85] p=0.0001; RCA 0.65 [0.55–0.75] p=0.0001), superior to territorial wall motion score index (Figure 1). The diagnostic value was confirmed in the subgroup of patients without wall motion abnormalities for TLS and for TCS, except for RCA. Conclusion Territorial strain assessed with STE might be a non-invasive tool to localize coronary artery stenosis in patients with NSTE-ACS, even without wall motion abnormalities. FUNDunding Acknowledgement Type of funding sources: None. Figure 1. ROC curve analyses

scholarly journals Exercise test predictors of severe coronary artery disease: Role of ST-segment elevation in lead aVR

2016 ◽  
Vol 40 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Giulio Russo ◽  
Salvatore Emanuele Ravenna ◽  
Antonio De Vita ◽  
Cristina Aurigemma ◽  
Priscilla Lamendola ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Exercise Test ◽  
Severe Coronary Artery Disease ◽  
St Segment Elevation ◽  
St Segment ◽  
Severe Coronary Artery ◽  
Lead Avr ◽  
Artery Disease

scholarly journals Pre-infarction angina – a problem more common than one might think. Role of general practitioners according to the 2019 ESC Clinical Practice Guidelines

2020 ◽  
Vol 16 (4) ◽  
pp. 389-395
Author(s):  
Małgorzata Wojciechowska ◽  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Artery Disease ◽  
Test Probability

Background and aims: Some patients present with stenocardial pain long before the onset of myocardial infarction. The aim of the study was to evaluate the mean frequency and duration of typical angina pectoris preceding ST-segment elevation myocardial infarction. In addition, the article addresses the role of general practitioners in the diagnosis of patients with suspected coronary artery disease. Material and methods: The study included a total of 120 patients without prior diagnosis of coronary artery disease who were admitted to the invasive cardiology department with ST-segment elevation myocardial infarction. All patients were assessed to determine symptoms preceding myocardial infarction and risk factors for coronary artery disease. In addition, their pre-test probability of disease was estimated. Results: Out of 120 patients, 43 (35.8%) presented with typical angina symptoms preceding myocardial infarction. The median duration of symptoms was 45 days (min 4, max 2,190 days!), and symptoms recurring for ≥2 weeks were found in 35 patients. The estimated pre-test probability of coronary artery disease was >15% in 40 (93%) patients, and the risk factors for coronary artery disease were prevalent. Conclusions: Typical exertional angina preceding myocardial infarction occurred in over 35% of patients. In some of them, it persisted for a number of months. The estimated probability of coronary artery disease in nearly all patients was >15%. Based on the collected data, the authors conclude that there is a need for broadly understood education so as to improve the understanding of typical anginal symptoms. Correct recognition of symptoms by physicians and patients can significantly reduce the incidence of myocardial infarction and, consequently, bring down the prevalence of heart failure, and decrease mortality rates in patients with coronary artery disease.

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