LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN ACROSS THE SPECTRUM OF COMPLEXITY OF STABLE CORONARY ARTERY DISEASE

Abstract

Objective: In patients with stable coronary artery disease left ventricular ejection fraction may remain within normal range. Myocardial strain is a precise tool for evaluation of early subclinical systolic function changes in a number of cardiac pathologies. Our aim was to determine if there is correlation between left ventricular global longitudinal strain (GLS) and complexity of coronary artery disease. Design and method: Study included stable coronary artery disease (SCAD) patients undergoing elective percutaneous coronary intervention (PCI). Patients with PCI in previous 3 months or target vessel, history of previous MI or atrial fibrillation at the time of study were excluded. No patients with medium or pronounced left ventricular hypertrophy, significant valvular pathology, hypo- or akinetic segments visually, or decreased ejection fraction were included. Complexity of coronary artery disease was calculated by SYNTAX score. Transthoracic echocardiography was performed on Philips iE33 the day before revascularization. Myocardial strain was determined by 2D speckle tracking on TOMTEC ARENA using 16-segment model and results were analysed by SPSS 22. Results: Study included 90 patients, mean age 64,6 years. Mean SYNTAX score was 12.63 (± 5.88). 76 patients had low SYNTAX score (< 18 points), 10 had medium SYNTAX score (18–27 points), 4 had high SYNTAX score. GLS was decreased in 75 (83.33 %) patients (mean GLS was -15.84 ± 5.19). Overall correlation between the SYNTAX score and GLS was weak: Spearman's rank correlation r = 0.30 (p = 0.002). In patients with decreased GLS correlation r was 0.41; p < 0.001. In patients with preserved GLS correlation was r = 0.336, p = 0.11. There was no significant difference between mean SYNTAX score when comparing groups with normal/decreased GLS. Conclusions: In this study left ventricular systolic function assessed by global longitudinal strain had a statistically significant weak correlation with complexity of coronary artery disease.