Layer‐specific global longitudinal strain reveals impaired cardiac function in patients with reversible ischemia

Abstract

In patients with SAP and preserved LVEF, layer-specific GLS at rest identifies patients with reversible ischemia. This seems to be evident only in patients with a true-positive SPECT, thus, 2DSTE at rest might improve the diagnostic accuracy of a positive SPECT.

Layer-specific strain analysis in patients with suspected stable angina pectoris and apparently normal left ventricular wall motion

“…Similarly, in the present study we also investigated patients who underwent elective coronary angiography with suspected SAP. Our results were also in agreement with the study by Hagemann et al [ 22 ], demonstrating that transmural, endocardial, and epicardial longitudinal strain (LS) values were all lower in patients with CAD compared with the control group. Additionally, in the current study, patients with true-positive and false-positive MPS were also compared and in line with the above-mentioned study, strain values were lower in all layers in patients with true-positive MPS (Table 6 ) [ 22 ].…”

“…Our results were also in agreement with the study by Hagemann et al [ 22 ], demonstrating that transmural, endocardial, and epicardial longitudinal strain (LS) values were all lower in patients with CAD compared with the control group. Additionally, in the current study, patients with true-positive and false-positive MPS were also compared and in line with the above-mentioned study, strain values were lower in all layers in patients with true-positive MPS (Table 6 ) [ 22 ]. Although it’s hard to draw a definite conclusion with this limited number of patients, these results also imply that 2D strain imaging might improve the diagnostic value of SPECT imaging, however, further prospective studies are needed.…”

“…Initially subendocardial area is affected and endocardial LS deteriorates before epicardial LS abnormalities become apparent [ 21 ]. In line with other studies, the present study demonstrated that, in addition to endocardial and transmural LS, epicardial LS values had also reduced in CAD patients [ 6 , 22 , 26 ]. It should be noted that although the deformation among the layers of the myocardium is heterogeneous, it’s not independent from each other.…”

“…The results demonstrated lower transmural and endocardial longitudinal strain values in lesions with FFR < 0.75. A recently published study assessed LSS in patients with reversible ischemia using MPS [ 22 ]. In conclusion, the study revealed that all layers of the myocardium were affected in patients with significant CAD and claimed that both GLS and LSS could increase the diagnostic accuracy of single-photon emission computed tomography (SPECT) imaging.…”

“…In contrast to the present study, endocardial layer was independently associated with CAD in the studies by Sarvari et al [ 26 ] and Zhang et al [ 6 ]. Additionally, as distinct from these studies, Hagemann et al [ 22 ] claimed that epicardial and mid-myocardial GLS were better predictors of CAD.…”