Assessment of Regional Left Ventricular Myocardial Strain in Patients with Left Anterior Descending Coronary Stenosis Using Computed Tomography Feature Tracking

Abstract

Background: Computed tomography feature tracking (CT-FT) has emerged as a valuable method for the assessment of cardiac function. However, no studies have investigated the usefulness of CT-derived assessments of left ventricular (LV) strain in coronary artery disease (CAD). Our aim was to evaluate regional LV systolic deformation in patients with left anterior descending coronary artery (LAD) stenosis using CT-FT.Methods: Seventy-six patients with LAD stenosis were enrolled. The patients were divided into four groups according to the percentage of LAD stenosis: ≤25% was defined as group I (24 patients), 26% to 49% as group II (17 patients), 50% to 74% as group III (21 patients), and ≥75% as group IV (14 patients). Thirty-two sex- and age-matched healthy subjects were included as controls.Results: No intergroup differences were found between groups I-IV and the controls in terms of the left ventricular ejection fraction, end-diastolic volume and end-systolic volume. However, the longitudinal strain (LS) of the LAD territory was significantly reduced in groups I-IV compared with the controls (-20.8%, -18.6%, -18.6%, and -17.0% vs -23.7%, respectively). The circumferential strain (CS) of the LAD territory was significantly reduced in groups III and IV compared with the controls and groups I and II (-22.4% and -22.1% vs -25.4%, -24.1%, and -25.3%, respectively). Compared with the non-LAD territory, the LAD territory in groups II-IV showed significantly increased LS (-18.6% vs -21.9%, p=0.07; -18.6% vs -21.9%, p=0.024; -17.5% vs -20%, p=0.032, respectively). The severity of LAD stenosis was positively correlated with the LS of the LAD territory (r = 0.438, p=0.002).Conclusion: CT‑FT can detect decreasing LV systolic function in patients with LAD stenosis. LV regional systolic deformation of the LAD territory was reduced with increasing LAD stenosis severity.

Cardiac Computed Tomography for Amyloidosis

“…By ECHO the septal to apical strain gradient or ratio predicted CA as did the deterioration in the global longitudinal strain (GLS) [26]. CT-based software has been used to measure GLS [54][55][56][57]. These approaches are early in their development but if adopted could help identify CA when performed as part of a comprehensive CT assessment.…”