The correlation between longitudinal strain echocardiography and extent of coronary artery disease in Patients with Suspected Stable Angina Pectoris
Fathy Swailem, Shaimaa Moustafa, Alaa galal and Khalid Elrabbat
Department of Cardiology, Benha Faculty of Medicine, Benha University, and National Heart Institute, Egypt Corresponding author: Dr. Fathy Swailem Department of Cardiology, Benha Faculty of Medicine, Benha University Tel: 00201014718777
fathyswailem@yahoo.com
Abstract
Introduction: Stable angina pectoris is a very common and disabling disorder. So it needs a rapid and right diagnosis to start a suitable therapy, the use of reliable non-invasive tests is usually necessary (1). The exercise and pharmacological stress testing has a good sensitivity for high risk patients either three-vessel and LM CAD, but the stress test has high risk for those groups (2). 2D STE showing early changes in strain or SR in patients with stable angina which may be an important diagnostic clue for CAD. Objective: to detect the role of global longitudinal peak systolic strain (GLPSS) performed during rest to predict the presence and extent of CAD in patients suspected stable angina pectoris. Methods: 200 candidates were evaluated by 2D STE, apical 4, apical 2 & apical long axis views. Global longitudinal peak systolic (GLPSS) was calculated. The results of the GLPSS were correlated to the results of coronary angiography for each patient. Results: There was a statistically significant difference in the mean global longitudinal peak systolic strain between normal coronaries & the different degrees of CAD. Global longitudinal peak systolic strain showed high sensitivity for the diagnosis of single vessel CAD (90%, specificity 95.1%, cutoff value: -18.44, AUC: 0.954); for two vessel disease (90%, sensitivity 88.9%, cutoff value -17.35, AUC:0.906 and for three vessel CAD (at cutoff value -15.33, sensitivity 63% & specificity 72.2% AUC 0.681) GLPSS also showed statistical significance for localization of the affected vessel. Conclusion: STE overcomes the many limitations of strain measurements acquired by tissue Doppler imaging .GLPSS can differentiate between normal coronaries &CAD and between different degrees of CAD severity & may localize the affected coronary artery.
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