Abstract
BackgroundAtherosclerosis is the underlying cause of the majority of myocardial infarctions and ischemic strokes. Carotid intima-media thickness (IMT) is a surrogate measure of atherosclerotic cardiovascular disease. Left ventricular (LV) function can be accurately assessed by 2D speckle-tracking strain echocardiography (2D-STE). The aim of this study was to assess the relationship between carotid IMT and LV dysfunction assessed by strain echocardiography in patients with coronary artery disease (CAD).MethodsThirty-one patients with symptoms of CAD were examined with coronary angiography, cardiac echocardiography and carotid ultrasound. Layer-specific longitudinal strains were assessed from endo-, mid- and epicardium by 2D-STE. LV global longitudinal strain (LVGLS) was averaged from 16 longitudinal LV segments in all 3 layers. LVGLS results were compared with coronary angiography findings in a receiver operating curve (ROC) to determine the cut-off for normal and pathological strain values. The calculated optimal strain value was compared to maximal carotid IMT measurements.ResultsThe ROC analysis for strain versus coronary angiography was: area under curve (AUC) = 0.91 (95% CI 0.80 – 1.0), cut-off value for endocardial LVGLS: -16.7%. Further analyses showed that increased carotid IMT correlated with low absolute strain values (p = 0.006) also when adjusted for hypertension, smoking, hyperlipidemia, diabetes and BMI (p = 0.02).ConclusionsIn this study increased carotid IMT values were associated with decreased LV function assessed by strain measurements. These findings support the use of carotid IMT measurements to predict the risk of coronary heart disease.
Highlights
Atherosclerosis is the underlying cause of the majority of myocardial infarctions and ischemic strokes
The aim of this study was to investigate a possible correlation between intima-media thickness (IMT) and Left ventricular (LV) function, assessed using strain echocardiography, in patients with coronary artery disease (CAD)
In this study we found a significant correlation between increased carotid IMT and LV dysfunction
Summary
Atherosclerosis is the underlying cause of the majority of myocardial infarctions and ischemic strokes. Carotid intima-media thickness (IMT) is a surrogate measure of atherosclerotic cardiovascular disease. Left ventricular (LV) function can be accurately assessed by 2D speckle-tracking strain echocardiography (2D-STE). The aim of this study was to assess the relationship between carotid IMT and LV dysfunction assessed by strain echocardiography in patients with coronary artery disease (CAD). The measurement of carotid intima-media thickness (IMT) has long been regarded as a method which can be used to evaluate the presence of generalized atherosclerotic arterial disease [1,2]. In some reports carotid IMT values have been related to left ventricular (LV) hypertrophy and function [3,4]. Strain is an intrinsic mechanical property which measures myocardial systolic function more accurately and has the ability to detect early pathological changes better than conventional cavity-based echocardiographic measurements [8,9,10]. Layer-specific 2D-STE allows the assessment of LV function in all 3 layers
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