Diagnostic accuracy of global longitudinal strain in prediction of severity and extent of coronary artery stenosis in patients with acute coronary syndrome

Mawla, Tamer Sayed Abdel; Wanees, Wesam Salah Abdel; Fattah, Eman Mahmoud Abdel; Khashab, Khaled Ahmed El; Momtaz, Osama

doi:10.1080/00015385.2022.2066810

Cited by 3 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 STE has shown promise in last 2 decades over and above conventional echocardiogram in various domains related to diagnosis and management of ACS patients. 4,5,13,14 However, these are still early days in laying down standardized guidelines and positioning STE in the algorithm of ACS management. This largely stems from the fact that most STE parameters have not been validated with the exception of GLS owing to large variations between the reported studies.…”

Section: Discussionmentioning

confidence: 99%

“…Tools like cardiac magnetic resonance has also gained wide acceptance in this regard but availability and slow turnaround times remains a concern besides the cost 12 . STE has shown promise in last 2 decades over and above conventional echocardiogram in various domains related to diagnosis and management of ACS patients 4,5,13,14 . However, these are still early days in laying down standardized guidelines and positioning STE in the algorithm of ACS management.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have shown the utility of STE in prediction of significant CAD amongst patients presenting with suspected ACS. 4,5,15 While most of the prior studies have focused on GLS and demonstrated its value in this regard, very few have shown the incremental value of GCS. In the study by Schroeder et al, both GCS and GLS provided significant incremental value to clinical risk scores and LVEF in prediction of significant CAD amongst suspected ACS patients.…”

Section: F I G U R Ementioning

confidence: 99%

“…Recent research has shown utility of speckle-tracking echocardiography (STE) in predicting significant CAD in myocardial infarction patients. 4,5 However, its diagnostic value in patients without global or RWMA has not been studied widely. Despite the initial promising results for global longitudinal strain (GLS) from small observational studies, a recent large multi-center study refuted all previous findings and gave GLS a status of an imaging marker with uncertain significance and they concluded that GLS has only a modest discriminatory ability to rule out significant CAD in suspected ACS patients.…”

Section: Introductionmentioning

confidence: 99%

“…Improvements in speckle‐tracking imaging allows detection of subtle global and segmental alterations in myocardial contraction secondary to an ischemic insult. Recent research has shown utility of speckle‐tracking echocardiography (STE) in predicting significant CAD in myocardial infarction patients 4,5 . However, its diagnostic value in patients without global or RWMA has not been studied widely.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Role of two‐dimensional strain echocardiographic parameters in suspected acute coronary syndrome patients with initial non‐diagnostic electrocardiogram and troponins: An observational study

et al. 2023

View full text Add to dashboard Cite

IntroductionDiagnosis of acute coronary syndrome (ACS) is often challenging especially in presence of initial normal troponins and non‐specific electrocardiogram. The index study aimed at determining the diagnostic value of strain echocardiography in patients with suspected ACS but with non‐diagnostic electrocardiogram and echocardiography findings.MethodsThe study was conducted on 42 patients with suspected ACS and non‐diagnostic electrocardiograms, normal quantitative troponin‐T levels, and left ventricular function. All patients underwent conventional and 2D‐strain echocardiography followed by coronary angiography, within 24 h of admission. Patients with regional wall motion abnormalities (RWMA), valvular heart disease, suspected myocarditis, and past coronary artery disease (CAD) were excluded.ResultsAmongst the global strains, the global circumferential strain (GCS) was significantly reduced (p = .014) amongst those with significant CAD on angiography as opposed to global longitudinal strain (GLS) which was similar in the two groups (p = .33). The GCS/GLS ratio was also significantly reduced in patients with significant CAD compared to those with normal/mild disease on coronary angiography (p = .025). Both the parameters had good accuracy in predicting significant CAD. GCS displayed a sensitivity of 80% and a specificity of 86% at an optimal cut‐off 31.5% (AUROC: .93, 95% CI: .601–1.000; p = .03), and likewise GCS/GLS ratio had a sensitivity of 80% and a specificity and 86% at a cut‐off of 1.89% (AUROC: .86, 95% CI: .592–1.000; p = .049). GLS and peak atrial longitudinal strain (PALS) did not differ significantly in patients with/without significant CAD (p = .32 and .58, respectively).ConclusionGCS and GCS/GLS ratio provides incremental value in comparison to GLS, PALS, and tissue Doppler indices (E/e’) in patients with suspected ACS and non‐diagnostic electrocardiogram and troponins. GCS at cut‐off of >31.5% and GCS/GLS ratio >1.89 can reliably exclude patients with significant CAD in this setting.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Role of two‐dimensional strain echocardiographic parameters in suspected acute coronary syndrome patients with initial non‐diagnostic electrocardiogram and troponins: An observational study

et al. 2023

View full text Add to dashboard Cite

show abstract

Special Issue on ischemic heart disease

et al. 2023

View full text Add to dashboard Cite

Usefulness of Longitudinal Strain to Assess Cancer Therapy-Related Cardiac Dysfunction and Immune Checkpoint Inhibitor-Induced Myocarditis

Tamura,

Tamura

2023

Pharmaceuticals

View full text Add to dashboard Cite

Longitudinal strain (LS) measured by echocardiography has been reported to be useful not only for the diagnosis and risk stratification of various cardiac diseases, but also in cardio-oncology. Most previous studies have been conducted on patients undergoing treatment with anthracyclines and human epidermal growth factor receptor 2-targeted therapies. Existing guidelines recommend that global LS (GLS) should be measured before and after the administration of cancer drugs. This recommendation is based on many reports showing that a decline in GLS is indicative of early or mild cancer therapy-related cardiac dysfunction. The main purpose of this article is to provide insight into the importance of LS in patients undergoing cancer treatment and highlight the role of LS evaluation in patients undergoing immune checkpoint inhibitor (ICI) treatment, which is being used with increasing frequency. Among cancer drug therapies, immune checkpoint inhibitors (ICIs) have an important place in cancer treatment and are used for the treatment of many types of cancer. Although the efficacy of ICIs in cancer treatment has been reported, immune-related adverse events (irAEs) have also been reported. Among these irAEs, cardiovascular complications, although rare, are recognized as important adverse events that may result in ICI treatment discontinuation. Myocarditis is one severe adverse event associated with ICIs, and it is important to standardize diagnostic and therapeutic approaches to it. Several studies have reported a relationship between LS and cardiac complications associated with ICIs which may contribute to the early diagnosis of ICI-induced cardiac complications.

show abstract

Diagnostic accuracy of global longitudinal strain in prediction of severity and extent of coronary artery stenosis in patients with acute coronary syndrome

Cited by 3 publications

References 12 publications

Role of two‐dimensional strain echocardiographic parameters in suspected acute coronary syndrome patients with initial non‐diagnostic electrocardiogram and troponins: An observational study

Role of two‐dimensional strain echocardiographic parameters in suspected acute coronary syndrome patients with initial non‐diagnostic electrocardiogram and troponins: An observational study

Special Issue on ischemic heart disease

Usefulness of Longitudinal Strain to Assess Cancer Therapy-Related Cardiac Dysfunction and Immune Checkpoint Inhibitor-Induced Myocarditis

Contact Info

Product

Resources

About