Ratio of transmitral early filling velocity to early diastolic strain rate predicts obstructive coronary stenosis

Abstract

ObjectiveThe aim was to evaluate the use of ratio of transmitral early filling velocity (E) to left ventricular early global diastolic strain rate (E′sr) (E/E′sr ratio) as a novel noninvasive predictor of obstructive coronary artery disease (OCAD) in patients with chronic coronary syndrome (CCS).BackgroundE′sr derived by speckle tracking echocardiography reflected global relaxation and filling pressure. Coronary artery disease caused early impairment of diastolic deformation.Patients and methodsIn all, 90 patients with CCS underwent coronary angiography in Mansoura Specialized Medical Hospital, Mansoura University. Patients were divided into two groups, which were age and sex matched: 55 patients with OCAD and 35 patients with normal coronary angiography. Global longitudinal strain (GLS), systolic strain rate (S′sr), and E′sr were measured by speckle tracking echocardiography.ResultsPatients with OCAD had significantly lower E′sr. On the other hand, they expressed significantly higher E/E′sr ratio, GLS, and S′sr. There was no significant difference between both groups regarding ejection fraction, E velocity, tissue Doppler-derived mitral annular velocity (E′ velocity), and E/E′ ratio. In patients with OCAD, significant positive correlation between E/E′sr ratio and E/E′ ratio, GLS, and Gensini and SYNTAX scores was observed. Independent predictors of OCAD in patients with CCS included diabetes mellitus, S′sr, and E/E′sr ratio. The ideal cutoff value of E/E′sr ratio of more than 154.29 cm predicted OCAD in patients with CCS.ConclusionTo the best of our knowledge, our study might be the first to show the possibility of use of E/E′sr ratio as a noninvasive predictor of OCAD in patients with CCS.