scholarly journals Speckle Tracking Echocardiography: Early Predictor of Diagnosis and Prognosis in Coronary Artery Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Maria Concetta Pastore ◽  
Giulia Elena Mandoli ◽  
Francesco Contorni ◽  
Luna Cavigli ◽  
Marta Focardi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Differential Diagnosis ◽  
Coronary Artery ◽  
Speckle Tracking ◽  
Ventricular Remodeling ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular Remodeling ◽  
Myocardial Damage ◽  
Left Ventricular ◽  
Artery Disease

Echocardiography represents a first level technique for the evaluation of coronary artery disease (CAD) which supports clinicians in the diagnostic and prognostic workup of these syndromes. However, visual estimation of wall motion abnormalities sometimes fails in detecting less clear or transient myocardial ischemia and in providing accurate differential diagnosis. Speckle tracking echocardiography (STE) is a widely available noninvasive tool that could easily and quickly provide additive information over basic echocardiography, since it is able to identify subtle myocardial damage and to localize ischemic territories in accordance to the coronary lesions, obtaining a clear visualization with a “polar map” useful for differential diagnosis and management. Therefore, it has increasingly been applied in acute and chronic coronary syndromes using rest and stress echocardiography, showing good results in terms of prediction of CAD, clinical outcome, left ventricular remodeling, presence, and quantification of new/residual ischemia. The aim of this review is to illustrate the current available evidence on STE usefulness for the assessment and follow-up of CAD, discussing the main findings on bidimensional and tridimensional strain parameters and their potential application in clinical practice.

scholarly journals P1319 Speckle tracking echocardiography in patients with acute coronary syndrome: the added value

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Di Lisi ◽  
A Polizzi ◽  
R Bentivegna ◽  
C Nugara ◽  
M Lunetta ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Dysfunction ◽  
Strain Measurement ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Coronary Artery Stenosis ◽  
Left Ventricular ◽  
Artery Disease

Abstract Background Speckle tracking echocardiography with assessment of left ventricular global longitudinal strain (GLS) allows to identify early signs of cardiac dysfunction. The superiority of GLS in the prediction of all-cause mortality in the general population compared with LVEF is well known; in addiction GLS improves risk stratification and recognize early left ventricular dysfunction in several clinical setting. Purpose the aim of this study was to assess the diagnostic and prognostic role of global and segmental strain in the early identification of cardiac dysfunction in patients with myocardial infarction without persistent ST segment elevation (NSTEMI) and without obvious wall motion abnormalities and to assess the ability to predict the presence/extension of coronary artery disease in this population. Methods an observational study was carried out enrolling 56 patients (median age 66 ± 11,7 years) admitted for NSTEMI. Electrocardiogram, echocardiogram with global and segmental strain measurement (GE’s Automated Function Imaging) and coronary angiography were performed in all patients. In addition we measured territorial longitudinal strain (TLS) defined as the mean of peak systolic strain of the segments pertinent to the perfusion territories of each epicardial coronary arteries in a 17-segment LV model. Results mean LVEF was 53%. We found a significant relationship between GLS values and coronary artery disease extension: GLS -19,1 % ±5,7% in patients without significant coronary artery stenosis, -18,74% ±4,85% in patients with one coronary artery disease, -15,6% ±4,3% in patients with two coronary artery disease, -14,2% ±5,4% in patients with 3 coronary artery disease (p = 0,03). We also found a correlation between territorial strain value and corresponding coronary artery stenosis. TLS was significantly reduced in patients with significant coronary disease of the perfused territory for each artery (LAD TLS 15,1% ± 6,74 % vs -20,73± 4,47 p = 0,002; CX TLS -11,42 % ± 6,59 %,vs -17,06 ± 7,1, p = 0,0 05 , RCA -14,02 % ± 6,00 % vs-17,6 ± 5,21 p = 0,02). At ROC analysis we identified a TLS value of -16,9 % to identify patients with significant stenosis of LAD (sensibility 58,3% and specificity 89,4%, AUC = 0,74, P < 0,001), TLS -18,2% for circumflex artery (sensibility 86,2% and specificity 78,9%, AUC = 0,78, P < 0,001) TLS -18% for right coronary (sensibility 73,9% and specificity 56,2%, AUC = 0,67, P = 0,027) Conclusions global and segmental strain measurement in patients with NSTEMI help to identify the presence and extension of significant coronary artery disease.

scholarly journals Left ventricular longitudinal strain impairment at rest correlates with reduction of SPECT-derived coronary flow reserve in patients with suspected coronary artery disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K M Cygulska ◽  
M Blaszczyk ◽  
J D Kasprzak ◽  
P Wejner-Mik ◽  
K Frynas-Jonczyk ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Flow ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Suspected Coronary Artery Disease ◽  
Left Ventricular ◽  
Flow Reserve ◽  
Artery Disease

Abstract Background Speckle tracking echocardiography (STE) may be useful for the detection of subclinical systolic function abnormalities. Dynamic acquisition of myocardial blood flow using 99mTc-MIBI SPECT-CZT gamma camera allows the calculation of coronary flow reserve (CFR). Purpose The aim of our study is to assess the relationship between left ventricular longitudinal strain (LS) and CFR in patients with suspected coronary artery disease (CAD). Methods 55 patients (pts) (43.6% females, mean age 64.6±8.4 years) with suspected CAD underwent transthoracic echocardiography with assessment global and local LS by STE. We calculated mean global left ventricular LS (GLS), as well as LS of individual coronary artery territories (LAD LS, LCx LS and RCA LS). All pts underwent myocardial perfusion study with novel solid-state CZT nuclear camera (dipyridamole stress protocol). We measured CFR of the left ventricle and individual coronary territories. Results Mean absolute GLS in pts with total CFR <2 was significantly lower than in pts with CFR >2 (median value −13.9 vs −18.3; p<0.001). Similar differences were observed in all three coronary territories (p≤0.01). Modest but significant correlations were detected between total CFR and GLS values (r=−0.56; p<0.001), LAD CFR and LAD LS (r=−0.54; p<0.001), RCA CFR and RCA LS (r=−0.36; p=0.007), LCx CFR and LCx LS (r=−0.53; p<0.001). GLS at rest had good diagnostic value for detecting total CFR <2 (AUC=0.767; p<0.001). The criterion with the highest diagnostic accuracy was GLS > (−15.8) – its sensitivity was 68%, specificity 77.7%, and overall accuracy 73%. Conclusions Indices of left ventricular longitudinal function obtained by speckle tracking echocardiography correlate with SPECT-derived CFR in patients with suspected CAD. FUNDunding Acknowledgement Type of funding sources: None.

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