Evaluation of Myocardial Ischemia with Myocardial Perfusion Scintigraphy and 2D- Speckle Tracking Echocardiography in Non-Obstructive Coronary Artery Patient Group

Abstract

Introduction: Strain analysis with 2D speckle tracking echocardiography could be used in the diagnosis of severe coronary artery disease. The aim of this study is to evaluate the effectiveness of 2D speckle tracking echocardiography in a group of patients with positive myocardial Perfusion Scintigraphy (MPS) but without severe coronary artery disease (CAD). Methods: Forty (25 female, age: 58.85±9.73) patients with the of angina pectoris and ischemia was found in MPS but non-obstructive CAD (<50% stenosis) was observed in coronary angiography was included. Strain analysis was performed in all patients using 2D speckle tracking echocardiography. Longitudinal strains weremeasured for 17 LV myocardial segments. LV segments were grouped as ischemic and non-ischemic segments according to MPS results and strain parameters of 680 segments were compared. Results: The mean longitudinal strain values of the segments with ischemia were -20.24±6.0%, and the segments without ischemia were found as -20.11±6.46%, and no statistically significant difference was observed (p>0.05). In subgroup analyzes based on gender, hypertension, diabetes mellitus, hyperlipidemia, and hypertriglyceridemia, no difference was observed between ischemic and non-ischemic segments in terms of longitudinal strain. Conclusion: In the patient group without severe coronary artery disease, no difference was observed between the staining parameters in the left ventricle 2D longitudinal strain analysis in terms of MPS positive segments and MPS negative segments. Considering previous studies, by using 2D strain analysis in combination with MPS, we can avoid unnecessary coronary artery angiography in special cases such as kidney failure, suspected MPS positivity.