Correlation between global longitudinal peak systolic strain and coronary artery disease severity as assessed by the angiographically derived SYNTAX score

Abstract

BackgroundIn this study, we investigate the correlation between reduced global longitudinal peak systolic strain (GLPSS) and the SYNTAX score (SS) in patients undergoing coronary angiography.MethodsWe examined 71 patients undergoing both echocardiogram and coronary angiography within 15 days. All patients had normal global and/or regional wall motion on resting echocardiogram. We calculated GLPSS using two-dimensional speckle-tracking echocardiography. SS was calculated for each group of patients based on the presence and/or the severity of coronary artery disease (CAD): no CAD on angiogram (n=10, control group), low SS (n=36, SS<22) and high SS (n=25, SS≥22). We hypothesised that GLPSS at rest is inversely correlated with the angiographically derived SS.ResultsAge, sex and most of the risk factors were equally distributed among the groups. There was a significant inverse correlation between GLPSS and SS values (r2=0.3869, P<0.001). This correlation was weaker in the low-SS group (r2=0.1332, P<0.05), whereas it was lost in the high-SS group (r2=0.0002, P=NS). Receiver operating characteristic curve analysis identified that the optimal cut-off for the detection of high-SS patients was 13.95% (sensitivity=71%, specificity=90%, P<0.001).ConclusionsThe results of our study suggest that GLPSS might be promising for the detection of patients with high SYNTAX score on coronary angiogram. There is an inverse correlation between resting GLPSS and SS as assessed by coronary angiography. In patients with the highest SS, however, the correlation with GLPSS was less significant.

The correlation between speckle tracking echocardiography and coronary artery disease in patients with suspected stable angina pectoris

“…In the present study, patients with normal coronary artery had small SD of GLPSS (-20.11 ± 0.8) that was in agreement with Hanan Radwan et al 12 where GLPSS of normal group was −18.65 ± 0.79, Sameh Bakhoum et al 13 where GLPSS of normal group −21.11 ± 0.8 and Vrettos et al 14 where GLPSS of normal group −17.39 ± 1.15.…”

“…Seventy patients (46.6%) had low syntax score (< 9), 45 patients (30%) had an intermediate syntax score 9, 10, 11, 12, 13, 14, 15, 16 and 35 (23.4%) had high syntax score (>16).…”

“…Vrettos et al 14 study was the first to correlate Syntax score and GLPSS in patients with stable angina with normal global and/or regional wall motion. The aim of this study was to investigate the hypothesis-generating idea, which can improve the selection of patients who are referred for coronary angiography.…”

Diagnostic Accuracy of Strain Imaging of the Left Ventricle in Detection of Obstructive Coronary Artery Disease

“…These results were supported by Vrettos et al, who correlated the global longitudinal peak systolic strain with the site and severity of coronary artery lesions assessed by coronary angiography [14].…”

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

“…6 Abnormal longitudinal mechanics have been described in the development of pathophysiological changes of CAD. 7 SYNTAX score (SS) has been used to determine severity of CAD during CAG. Correlation between global longitudinal peak systolic strain (GLS) and severity of CAD assessed by SS has been described in two studies from United Kingdom and Egypt but no such data exist in Indian population till date for subjects with stable ischemic heart disease (SIHD).…”