Utility of global longitudinal strain to detect significant coronary artery disease, its extent and severity in patients with stable ischemic heart disease

2020 ◽  
Vol 37 (12) ◽  
pp. 2000-2009
Author(s):  
Kaushik Biswas ◽  
Anindya Mukherjee ◽  
Saumen Nandi ◽  
Dibbendhu Khanra ◽  
Ranjan Kumar Sharma ◽  
...  
Author(s):  
Anders B. Mathiasen ◽  
Marina J. Harutyunyan ◽  
Erik Jørgensen ◽  
Steffen Helqvist ◽  
Rasmus Ripa ◽  
...  

2019 ◽  
Vol 60 (3) ◽  
pp. 527-538 ◽  
Author(s):  
Alireza Sepehri Shamloo ◽  
Boris Dinov ◽  
Livio Bertagnolli ◽  
Philipp Sommer ◽  
Daniela Husser-Bollmann ◽  
...  

2011 ◽  
Vol 57 (14) ◽  
pp. E1149 ◽  
Author(s):  
Anders B. Mathiasen ◽  
Marina J. Harutyunyan ◽  
Erik Jørgensen ◽  
Steffen Helqvist ◽  
Rasmus Ripa ◽  
...  

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M I Bolog ◽  
M Dumitrescu ◽  
E Pacuraru ◽  
F Romanoschi ◽  
A Rapa

Abstract Background Previous studies demonstrated that 2 D strain imaging segmental transverse diastolic index is a marker of regional ischemia and that global longitudinal strain diastolic index (GLSDI) correlates with left ventricular (LV) filling pressures and NTproBNP. However, usefulness of GLSDI in clinical practice has to be established. Purpose The aim of the study is to examine the utility of global longitudinal strain diastolic index in the assessment of patients with suspected ischemic heart disease (IHD). Methods We performed 2 D standard echocardiography and strain imaging in 30 healthy subjects and in 148 patients with stable angina with indication for coronarography. Patients with severe symptoms, severe valvulopathy, arrythmia and/or ejection fraction (EF) less than 45% were excluded. Standard echocardiographic parameters, left ventricular global longitudinal strain (LVGLS) and global longitudinal strain diastolic index were analysed. The patients subsequently underwent coronary angiographic examination. Results GLSDI was significantly lower in angina pectoris vs control group (0.41 vs 0,69, p <0.001). After coronarography patients were divided in three subgroups: 74 patients (50%) with more than 50% obstruction in any major artery, 26 patients (17.5%) with previous revascularisation but no significant obstructive lesions at present and 48 patients (32.5%) without obstructive artery disease. Average GLSDI was significantly lower in the subgroup with obstructive coronary disease vs the other two subgroups (0.32 vs 0.41 and 0.46 respectively, p < 0.05). Mean LVEF was different in subgroups but with no statistical significance (50 % vs 48 % vs 54 %, p= 0.08). Mean LVGLS was lower in the obstructive artery disease subgroup (-16.4% vs -18.2% vs -21% respectively, p< 0.05). In univariate analysis lower GLSDI was associated with a higher risk of coronary artery disease (Hazard Ratio 1.39, 95% Confidence Interval 1.09-1.49; p < 0.05 per 0.1% decrease). There was significant correlation between reduced GLSDI and the presence of coronary artery disease (r= -0,54, P < 0.05), hypertension (r=- 0.61, p < 0.05), left ventricular hypertrophy (-0.68, p < 0.05) and diastolic disfunction (-0.69, p < 0.05). GLSDI lower than 0.5 had a good sensitivity (84%) and negative predictive value (71%) and a lower specificity (40%) and positive predictive value (52%) for detection of ischemic heart disease. Conclusions Global longitudinal strain diastolic index is significantly lower in patients with stable angina and normal or borderline reduced ejection fraction compared with normal subjects. A cut off value lower than 0.5 selects patients with a higher probability of obstructive coronary heart disease.


2020 ◽  
Vol 26 ◽  
Author(s):  
Maria Bergami ◽  
Marialuisa Scarpone ◽  
Edina Cenko ◽  
Elisa Varotti ◽  
Peter Louis Amaduzzi ◽  
...  

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.


Author(s):  
Harindra C Wijeysundera ◽  
Feng Qiu ◽  
Maria C Bennell ◽  
Madhu K Natarajan ◽  
Warren J Cantor ◽  
...  

Background: Wide variation exists in the diagnostic yield of coronary angiography in stable ischemic heart disease (IHD). Previous work has primarily focused on patient factors for this variation. We sought to understand if system and physician factors, specifically hospital and physician type, as well as physician self-referral, have incremental impacts on the yield of coronary angiography, above and beyond that of patient factors alone. Methods: All patients who underwent a diagnostic coronary angiogram for possible stable IHD, at the 18 cardiac centers in Ontario, Canada were identified from October 1st, 2008 to September 30th, 2011. Obstructive coronary artery disease was defined as stenosis greater than 70% in the main coronary arteries or greater than 50% in the left main artery. Physicians were classified as either invasive or interventional. Hospitals were categorized into cath only, stand-alone PCI and full service centers. Multi-variable hierarchical logistic models were developed to identify system and physician level predictors of obstructive coronary artery disease, having adjusted for patient factors. Results: Our cohort consisted of 60,986 patients who underwent a diagnostic angiogram for possible stable IHD, of which 33,483 had obstructive coronary artery disease (54.9%), ranging from 41.0% to 70.2% across centers. Self-referral rates varied from 4.8% to 74.6%. Fewer self-referral patients (52.5%) had obstructive coronary artery disease compared to non-self-referral patients (56.5%), with an odds ratio (OR) of 0.89 (95% CI 0.85-0.93;p <0.001), after accounting for patient factors. Angiograms performed by interventional physicians had a higher likelihood of showing obstructive coronary artery disease (60.1% vs. 50.8%; OR 1.22; 95% CI 1.17-1.28; p<0.001). Fewer angiograms at cath only centers showed obstructive disease (45.0%) compared to full service centers (58.1%); this was of borderline significance (OR 0.59; 95% CI 0.34-1.00; p=0.05). Conclusion: Physician and system factors are important predictors of the diagnostic yield of coronary angiography in stable IHD, even after accounting for patient characteristics. Further study into the drivers of how these physician and system factors impact diagnostic yield is an important focus for quality improvement.


1982 ◽  
Vol 63 (3) ◽  
pp. 15-17
Author(s):  
E. V. Tsybulina ◽  
L. A. Emelyanova

A comparative analysis of the effectiveness of antianginal drugs (papaverine, persantine, intensain, nitrong, anaprilin) in combination with climacteric myocardial dystrophy in women was carried out. The data obtained make it possible to recommend beta-blockers (anaprilin, obzidan) for the treatment of coronary artery disease in women against the background of pathological menopause for wider use.


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