scholarly journals Role of global longitudinal strain diastolic index in assessment of patients with suspected obstructive coronary artery disease and normal or mildly reduced ejection fraction

2020 ◽  
Vol 30 (2) ◽  
pp. 222-229
Author(s):  
Mihaela Bolog ◽  
Mihaela Dumitrescu ◽  
Florentina Romanoschi ◽  
Elena Pacuraru ◽  
Alina Rapa
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Obstructive Coronary Artery Disease ◽  
Global Longitudinal Strain ◽  
Strain Imaging ◽  
Control Group ◽  
Reduced Ejection Fraction ◽  
Artery Disease

Objective – To examine the utility of global longitudinal strain imaging diastolic index (SI-DI) in the assessment of patients with suspected obstructive coronary artery disease (CAD). Methods – We performed rest 2D standard echocardiography and strain imaging in 30 healthy subjects and in 148 patients with normal or mildly reduced ejection fraction and indication for coronarography for suspected obstructive CAD. Standard echocardiographic and strain parameters were analysed. Results – Global SI-DI was signifi cantly lower in the selected vs control group (p <0.001). After coronarography patients were divided in three subgroups: 74 patients with more than 50% obstruction in any major artery, 26 patients with previous revascularisation but no significant obstructive lesions at present and 48 patients without obstructive artery disease. Average global SI-DI was significantly lower in the subgroup with obstructive CAD vs the other two subgroups (p<0.05). Global SI-DI lower than 0.5 had a good sensitivity (84%) and a reasonable positive predictive value (52%) for detection of obstructive CAD. Conclusions – Global SI-DI is significantly lower in patients with obstructive CAD and normal or mildly reduced ejection fraction compared with normal subjects. A cut off value lower than 0.5 selects patients with a higher probability of obstructive CAD.

scholarly journals P1539 Role of global longitudinal strain diastolic index in assessment of coronary artery disease in patients with stable angina and normal or borderline ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M I Bolog ◽  
M Dumitrescu ◽  
E Pacuraru ◽  
F Romanoschi ◽  
A Rapa
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Ischemic Heart Disease ◽  
Stable Angina ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Artery Disease

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 &lt;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 &lt; 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&lt; 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 &lt; 0.05 per 0.1% decrease). There was significant correlation between reduced GLSDI and the presence of coronary artery disease (r= -0,54, P &lt; 0.05), hypertension (r=- 0.61, p &lt; 0.05), left ventricular hypertrophy (-0.68, p &lt; 0.05) and diastolic disfunction (-0.69, p &lt; 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.

DIAGNOSTIC VALUE OF GLOBAL LONGITUDINAL STRAIN IN PATIENTS WITH CORONARY ARTERY DISEASE

2021 ◽  
Vol 74 (10) ◽  
pp. 2588-2592
Author(s):  
Oksana Yu. Marchenko
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Control Group ◽  
Instrumental Method ◽  
Syntax Score ◽  
Group I ◽  
Artery Disease

The aim: To investigate the global longitudinal strain (GLS) in patients with preserved left ventricle systolic function and the presence of varying degrees of coronary artery disease. Materials and methods: The study is based on data obtained during a prospective analysis of 131 patients aged 51 to 82 years in the period from January to December 2019,whose complaints indicate coronary heart disease. The main instrumental method of examination was coronary angiography, patients were divided into 3 groups according to the results. The control group (group I) consisted of 30 patients in whom no coronary artery disease was detected; patients with single vessel lesions or non-stenotic coronary atherosclerosis were included into group II (n = 35) and patients with multivessels lesions (n = 66) were included in group III. For each patient, the extent of the lesion was assessed using the SYNTAX Score. The groups were comparable in age, sex and comorbidities. Results : GLS was -19.71 ± 2.22 (SI -18.88 to -20.54%) in the group without coronary lesions, the group with multivessel lesions was the lowest -14.34 ± 3.47 (SI -13.49 to -15.2%). There was a significant correlation between GLS average and LV EF (r = 0.681; p <0.0001), LV ESV (r = -0.576; p <0.0001), EPSS (r = -0.528; p <0.0001). A moderate correlation was observed GLS, linear and volumetric parameters. Conclusions: Global longitudinal strain is recommended for echocardiographic assessment of patients with coronary artery disease, as one of the main areas of application of this technique because its use provides additional information and maybe used in the same patient to assess the treatment.

scholarly journals Importance of two-dimensional strain imaging in diagnosis of coronary artery disease

2019 ◽  
Vol 60 (4) ◽  
pp. 179-184
Author(s):  
Ahmed M. Hussein ◽  
Mahdi S. Alzaidi ◽  
Bashar M. Abed
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Sensitivity And Specificity ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Significant Coronary Artery Disease ◽  
Strain Imaging ◽  
Left Ventricular ◽  
Two Dimensional ◽  
Artery Disease

Background: Strain imaging assessing regional myocardial deformation and can be used to quantify regional myocardial function and differentiate between ischemic and non ischemic myocardium. Objectives: to assess sensitivity and specificity of strain imaging in detection of coronary artery disease in comparison with coronary angiography.Patients and Methods: ninety six patients were referred to Ibn albitar center for cardiac surgery, Baghdad, Iraq with symptoms of coronary artery disease for a period between June 2014 and April 2015, all of whom were evaluated by two dimensional echocardiography and all were found to have good left ventricular systolic function with no regional wall motion abnormalities (RWMA), coronary angiography were done for all patients. Results: of the 96 patients: 69(71.9%) were males and 27(28.1%) females, with mean age 55.7 ± 9.71 years. Thirty-one (32.3%) patients have no significant coronary artery disease and sixty-five (67.7%) have significant coronary artery disease. The sensitivity and specificity of global longitudinal strain in detection of coronary artery disease are 67.7% and 80.6% respectively. Global longitudinal strain appears to be useful in localization of coronary artery disease. Conclusions: speckle tracking Strain echocardiography is simple, noninvasive and non-angle dependent with acceptable sensitivity and specificity in early detection of cardiomyopathy including ischemic myopathy.

scholarly journals Syncope due to non-sustained episodes of Torsade de Pointes associated to androgen-deprivation therapy use: a case presentation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ximena Morales ◽  
Diego Garnica ◽  
Daniel Isaza ◽  
Nicolas Isaza ◽  
Felipe Durán-Torres
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Androgen Deprivation Therapy ◽  
Torsade De Pointes ◽  
Androgen Deprivation ◽  
Atrial Pacing ◽  
Case Presentation ◽  
Reduced Ejection Fraction ◽  
Artery Disease

Abstract Background Abiraterone is a medication frequently used for metastatic castrate-resistant prostate cancer. We report a case of non-sustained episodes of TdP associated with severe hypokalemia due to androgen-deprivation therapy. Few case presentations describe this association; the novelty lies in the potentially lethal cardiovascular events among cancer patients receiving hormonal therapy. Case presentation A 70-year-old male presented with recurrent syncope without prodrome. ECG revealed frequent ventricular ectopy, non-sustained episodes of TdP, and severe hypomagnesemia and hypokalemia. During potassium and magnesium infusion for repletion, the patient underwent temporary transvenous atrial pacing. As part of the work-up, coronary angiography revealed a mild coronary artery disease, and transthoracic echocardiogram showed a moderately depressed ejection fraction. After electrolyte disturbances were corrected, the QT interval normalized, and transvenous pacing was no longer necessary. Abiraterone was discontinued during the admission, and the patient returned to baseline. Conclusions Cancer treatment is complex and requires a multidisciplinary approach. We presented a case of non-sustained TdP associated with androgen-deprivation therapy in an elderly patient with mild coronary artery disease and moderately reduced ejection fraction. Close follow-up and increased awareness are required in patients with hormonal treatment, especially in the setting of other cardiovascular risk factors.

scholarly journals NETWORK META-ANALYSIS OF REVASCULARIZATION STRATEGIES FOR PATIENTS WITH CORONARY ARTERY DISEASE AND REDUCED EJECTION FRACTION

2021 ◽  
Vol 77 (18) ◽  
pp. 75
Author(s):  
Yujiro Yokoyama ◽  
Shinichi Fukuhara ◽  
Makoto Mori ◽  
Masahiko Noguchi ◽  
Hisato Takagi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Meta Analysis ◽  
Reduced Ejection Fraction ◽  
Artery Disease
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