Identification of significant coronary artery disease in patients with non‐ST segment elevation acute coronary syndrome by myocardial strain analyses using three‐dimensional speckle tracking echocardiography

Biswas, Asim; Haque, Tuhin; Banik, Dhiman; Choudhury, Sohel Reza; Khan, Sayeedur Rahman; Malik, Fazila Tun Nesa

doi:10.1111/echo.14181

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…The patients were categorized upon presence of signi cant stenosis in the coronary angiography to two groups. (21) All strain parameters were signi cantly reduced in patient group of signi cant stenosis. Receiver operating characteristic (ROC) curve analysis demonstrated that GPSLS could effectively detect patients with signi cant stenosis (area under ROC curve = 0.840, 95% CI = 0.735-0.945).…”

Section: Discussionmentioning

confidence: 88%

Value of Two-Dimensional Speckle Tracking at Rest and During Dobutmaine Stress Echocardiography in Diagnosis of Coronary Artery Disease

Saleh

Zintl

Mohrez

et al. 2021

Preprint

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IntroductionCAD (coronary artery disease) is a major cause of death and disability in developed countries. Exercise testing is recommended as a first-line diagnostic test in patients with stable angina pectoris. However, the limited sensitivity and specificity have been criticized. Myocardial strain can predict the presence of significant coronary artery disease.Aim of workto assess the utility of myocardial strain obtained by 2D-speckle tracking at rest and under stress for the detection of CAD in patients referred to chest pain unit with stable and low risk unstable angina pectoris.Methods108 individuals matched the inclusion criteria and gave their written consent to be enrolled in this study. Coronary angiography was performed within 48 hours from admission to the chest pain unit. Myocardial strain by 2D-speckle tracking was obtained at rest and under dobutamine stress.ResultsGlobal longitudinal strain at stress revealed a moderate correlation with the presence of significant CAD; r= 0.41, p <0.0001. While a moderate correlation was established between global strain under stress with the severity of coronary occlusion, r= 0.62, p <0.0001. Global longitudinal strain under stress showed a sensitivity of 74.1% and a specificity of 76.7% in detecting significant CAD at a cut-off value of -19.1.ConclusionLongitudinal strain parameters at rest and under stress could predict the presence of coronary artery disease in patients with stable angina pectoris. The obtained strain data could add value in detecting the severity of CAD.

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Section: Discussionmentioning

confidence: 88%

Value of Two-Dimensional Speckle Tracking at Rest and During Dobutmaine Stress Echocardiography in Diagnosis of Coronary Artery Disease

Saleh

Zintl

Mohrez

et al. 2021

Preprint

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“…We used a conventional AVA index of .6cm 2 /m 2 as the cutoff value 20 for severe AS, and the AVA index was significantly reduced in all members of the AS group compared to control (.29 ± .10cm 2 /m 2 compared to 2.03 ± .18cm 2 /m 2 , p < .001).Among the 2D echocardiographic findings (Table 3), the interventricular septum (IVS) and posterior wall were found thicker in patients with AS than in the controls (…”

Section: Resultsmentioning

confidence: 99%

“…Standard 3D STE was performed. 20 In the final phase, automated 3D STE strain analyses were presented as curves with color-coded LV 17 segments in a bull's-eye plot. 21 As weighted averages of the regional values from the 17 myocardial segments, global values for longitudinal, circumferential, radial, and area strains were calculated.…”

Section: D Speckle Tracking Echocardiographymentioning

confidence: 99%

Assessment of subclinical left ventricular systolic dysfunction in patients with asymptomatic severe aortic stenosis with preserved left ventricular systolic function by three‐dimensional speckle tracking echocardiography

et al. 2023

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ObjectivesLeft ventricular dysfunction and remodeling can occur as a result of aortic valve stenosis (AS). Three‐dimensional speckle tracking echocardiography (3D‐STE) can detect early left ventricular myocardial dysfunction even before ejection fraction declines. The purpose of this study was to look at the relationship between various myocardial strain parameters measured by 3D‐STE in asymptomatic severe AS patients from Bangladesh.MethodsThis study included 46 patients with asymptomatic severe AS but preserved LV systolic function (mean age 50.11 ± 12.66 years, LVEF 63.78 ± 3.95%, AS group) and 33 healthy subjects with no cardiovascular disease (mean age 48.21 ± 4.53 years, LVEF 65.15 ± 3.13%, control group). 3D‐STE was used to measure left ventricular global myocardial strain parameters such as peak systolic longitudinal strain (PSLS), circumferential strain, radial strain, and area strain.ResultsThe AS group had significantly thicker interventricular septum and posterior ventricular wall than the control group (1.49 ± .19 cm vs. .81 ± .09 cm, p < .001; 1.73 ± 1.71 cm vs. .81 ± .10 cm, p = .003, respectively.) In the AS group, the Indexed Aortic Valve Area (AVA) was significantly lower than in the control group. (.29 ± .10 vs. 2.03 ± .18, p < .001, respectively). In terms of LVEF (p = .102), left ventricular end diastolic volume (p = .075), or left ventricular end systolic volume (p = .092), no significant inter‐group difference was found. However, global PSLS (−10.75 ± 2.27 vs. −16.42 ± 2.76, p < .001), circumferential strain (−14.26 ± 3.40 vs. −16.64 ± 2.56, p = .001), area strain (−22.70 ± 4.19 vs. −26.45 ± 9.90, p = .024) and radial strain (32.20 ± 8.77 vs. 41.00 ± 7.52, p < .001) in the AS group were significantly lower than in the control group.ConclusionOur findings showed reductions in left ventricular global myocardial strains, particularly PSLS in patients suffering from asymptomatic severe AS in Bangladesh; this is consistent with other studies. Reduced area strain, detectable with 3D‐STE, is also consistent with that pattern.

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“…GLS was demonstrated to effectively identify patients with significant stenosis via receiver operating characteristic curve analysis (area under ROC curve = 0.840, 95% confidence interval = 0.735–0.945). GLS with a cutoff value of −13.50% showed good sensitivity and specificity for detecting significant stenosis [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Combining Stress Speckle Tracking with High-Sensitivity C-Reactive Protein in Diagnosis of Coronary Artery Disease

Saleh¹,

Zintl

Brachmann

2022

JCDD

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Introduction: CAD (coronary artery disease) is a leading cause of death and disability in developed nations. Exercise testing is recommended as a first-line diagnostic test for patients with stable angina pectoris. In addition to myocardial strain, high-sensitivity CRP (hs-CRP) can predict the presence of significant coronary artery disease. Aim of work: The purpose of this study was to demonstrate the utility of 2D-speckle tracking at rest and under stress along with hs-CRP for detection of CAD in patients who were referred to the chest pain unit with stable or low risk unstable angina pectoris. Methods: A total of 108 individuals met the inclusion criteria and gave their written consent to participate in this study. Coronary angiography was performed within 48 h after admission to the chest pain unit. Myocardial strain was recorded at rest and during dobutamine administration. Results: Global longitudinal strain at stress appeared to be moderately correlated with the presence of significant coronary artery disease (CAD); r = 0.41, p < 0.0001. A moderate correlation was also found between global longitudinal strain at stress and the severity of coronary occlusion; r = 0.62, p < 0.0001. With a cut-off value of −19.1, global longitudinal strain under stress had a sensitivity of 74.1% and a specificity of 76.7% for detecting significant CAD. Hs-CRP was significantly higher in patients with manifested CAD. Conclusion: Evaluation of longitudinal strain parameters at rest and under stress may predict coronary artery disease in patients with stable angina pectoris. A measurable Hs-CRP is a potential marker of coronary stenosis. Strain data could assist in diagnosing CAD severity.

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Identification of significant coronary artery disease in patients with non‐ST segment elevation acute coronary syndrome by myocardial strain analyses using three‐dimensional speckle tracking echocardiography

Cited by 10 publications

References 30 publications

Value of Two-Dimensional Speckle Tracking at Rest and During Dobutmaine Stress Echocardiography in Diagnosis of Coronary Artery Disease

Value of Two-Dimensional Speckle Tracking at Rest and During Dobutmaine Stress Echocardiography in Diagnosis of Coronary Artery Disease

Assessment of subclinical left ventricular systolic dysfunction in patients with asymptomatic severe aortic stenosis with preserved left ventricular systolic function by three‐dimensional speckle tracking echocardiography

Combining Stress Speckle Tracking with High-Sensitivity C-Reactive Protein in Diagnosis of Coronary Artery Disease

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