Abstract 18146: Stress Speckle Tracking Imaging Parameters of Circumferential Deformation in Assesssing Ischemia for Patients With Moderate and High Probability of Coronary Artery Disease

Abstract

Introduction: Value of longitudinal strain and strain rate (SR) at rest and low dobutamine doses has been shown in small studies however little is known about circumferential strain, circumferential systolic and diastolic SR importance in early stages of dobutamine speckle tracking echocardiography (STE). Hypothesis: Hypothesis that circumferential strain, circumferential systolic and diastolic SR in early stages of dobutamine STE are markers of significant coronary stenosis in patients with moderate and high probability of coronary artery disease (CAD) was assessed. Methods: Dobutamine stress echocardiography and adenosine magnetic resonance imaging were perfomed to 101 patients with moderate and high probability of CAD. CAD was defined as ≥50% diameter stenosis on coronary angiography validated as hemodynamically significant by adenosine magnetic resonance. Patients were divided into two groups based on coronary angiography results: CAD (-) n=57 (56,44%) vs CAD (+) n=44 (43,56%). Circumferential strain, circumeferential systolic and early diastolic SR parameters at rest, low and high dobutamine doses were analysed using 2D STE. Results and Conclusions: There were no significant differences of clinical characteristics, conventional echocardiography and deformation parameters between the groups at rest. All analysed STE parameters at low dobutamine doses were significantly lower in patients wtih CAD (circumferential strain 23,84±7,25% vs 17,98±4,06%, p=0,01, circumferential systolic SR 2,70±0,74 s–1 vs 1,76±0,75 s–1, p=0,002; circumferential early diastolic SR 2,71±0,74 s–1 vs 1,76±0,75 s–1, p=0,002). Logistic regression analysis revealed that STE parameters at low dobutamine doses have significant predictive value for haemodinamically significant coronary stenoses. Circumferential strain, systolic and early diastolic SR obtained at low dobutamine doses are sensitive and specific markers of haemodynamically significant CAD.