Abstract
Purpose: To determine if 2-Dimensional Strain Echocardiography (2DSE) performed at rest in patients with suspected Stable Angina Pectoris (SAP) is able to improve the diagnosis of the presence of significant Coronary Artery Disease (CAD). Methods: In total 296 consecutive patients with clinically suspected SAP, no previous cardiac history and a normal ejection fraction were included. All patients were examined by 2DSE, Exercise Electrocardiogram (ECG) and coronary angiography. 2DSE was performed in the three apical projections. Peak Regional Longitudinal Systolic strain (RLS) was measured in 18 myocardial sites and averaged to provide Global Longitudinal Systolic strain (GLS). Duke Score (DS), including ST-depression, chest pain and exercise capacity, was used as the outcome of the exercise ECG. Results: Patients with an area stenosis ≥70% in at least one epicardial coronary artery were categorized as having significant CAD (n=108). GLS was significantly lower in patients with CAD compared to patients without CAD (17.1% vs. 18.8%, p<0.001), and remained an independent predictor of CAD after multivariable adjustment for baseline data, exercise ECG and conventional echocardiographic parameters (OR 1.17 (1.0-1.3, p=0.012) per 1% decrease). Area under receiver operating characteristics curve (AUC) for exercise ECG and GLS in combination was significantly higher than AUC for exercise ECG alone (0.84 vs. 0.78, p<0.004). Furthermore, RLS predicted significant stenosis in corresponding coronary arteries (Figure 1). ![Figure][1] Figure 1. RLS in stenotic vs non-stenotic segments Conclusion: In patients with suspected SAP GLS at rest is an independent predictor of significant coronary artery disease and significantly improves the diagnostic performance of exercise ECG. Additionally, RLS can identify which coronary artery that suffers from significant stenosis. [1]: pending:yes
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
