Two-dimensional speckle tracking for the assessment of coronary artery disease during dobutamine stress echo: clinical tool or merely research method

Abstract

BackgroundTwo-dimensional speckle tracking provides valuable information for regional wall motion abnormalities. The purpose of this study was to determine the diagnostic value of left ventricular longitudinal strain and torsion to diagnose coronary artery disease during dobutamine stress echocardiography.MethodsWe studied 100 patients (mean age 60.8 ± 10.7 years, 72 male) with known or suspected coronary artery disease, excluding those with prior history of transmural infraction. All of them underwent dobutamine stress echo and coronary angiography within one month. Wall-motion score index, left ventricular global longitudinal strain and torsion were measured at rest and peak stress. Additionally, the respective differences between rest and stress were also calculated. Optimal cut-offs were derived from receiver operating characteristic curves for strain and torsion values.ResultsMean left ventricular ejection fraction was 55 ± 5.4 %. Coronary angiography revealed significant lesions in 67 patients. Values regarding sensitivity, and specificity for wall motion score index difference were 78 % and 88 % respectively (area under curve 0.84). Global longitudinal strain difference (median 0.5 %) illustrated 81 % sensitivity and 72 % specificity for disease detection (area under curve 0.80, cut-off value ≤0 %). The respective values for torsion difference (median 4.7°) were 81 % and 82 % (area under curve 0.76, cut-off value ≤6.5°). Combination of wall motion score index difference and torsion difference for disease detection showed 91 % sensitivity and 79 % specificity (area under curve 0.85).ConclusionsThe implementation of speckle tracking during dobutamine stress echo could serve as an adjunct method for coronary artery disease assessment, providing quantitative diagnostic information.

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

“…Recently, several studies have proven the ability of 2DSTE to detect CAD and impaired cardiac function solely from a resting echocardiographic examination . This is in line with previous findings, demonstrating how recurrent ischemia and cumulative stunning can lead to chronic LV dysfunction.…”

The Value of Longitudinal Strain versus Coronary Angiography in Detection of Coronary Artery Disease

“…This is not consistent with that mentioned by Aggeli et al where the main percentage was found in one vessel (46%), 14% in two vessels and 7% in three vessels [17]. This may be attributed to the difference in sample selection as in the last study only 67% of the patients had coronary artery disease.…”

“…Aggeli Constantina et al reported that the sensitivity for detection of coronary artery disease was 38%, 29% and 28% in LAD, LCX and RCA respectively [17].…”

Layer‐specific strain in dipyridamole stress echo: A new tool for the diagnosis of microvascular angina

“…Speckle Tracking Echocardiography (STE) allows an objective and quantitative evaluation of ventricular deformation . In SE, it is a valuable detector of left ventricular (LV) systolic function abnormalities beyond the evaluation of wall motion . The last releases of the EchoPac for STE analysis of LV longitudinal (LS) and circumferential strain (CS) evaluate each LV wall layer.…”