Segmental speckle tracking strain and strain rate in stable coronary artery disease

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Northern Norway Regional Health Authority Background It is known that patients with coronary artery disease (CAD) display reduced global and regional strain and strain rate (SR). However, knowledge about segmental strain and SR in stable CAD patients is still limited. Purpose The purpose of this study was to explore whether segmental strain and SR analyses are different between patients with normal and stenotic coronary arteries among individuals with chest-pain. Methods A total of 510 patients with chest pain, referred to coronary computed tomography angiography (CCTA) and additional 102 patients with myocardial infarction (MI) were prospectively included. All patients underwent transthoracic echocardiography (TTE) with strain-rate analysis. All patients with CCTA-suspected CAD subsequently underwent invasive CAG, as well as in all MI patients. Global longitudinal strain (GLS) and average for segmental peak longitudinal strain during systole (PLS), peak systolic strain rate (PLSR S), peak early diastolic strain rate (PLSR E), post systolic shortening (PSS) measurements were analysed. Further, different cut-off values for reduced strain and SR were used to define the percentage of functionally reduced segments between patients with normal CAD (no CAD), MI, and stable CAD patients who were further treated by percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). Results As shown in the table 1, all average segmental strain and SR parameters differed significantly between no CAD and MI groups. However, only PLSR E showed significant differences between no CAD and PCI groups . PLSR E, PLS and GLS showed significant differences between no CAD and CABG groups. The percentage of reduced segmental strain and SR showed similar results. Regarding the percentage of pathological segments at different cut-off values, PLSR E showed the most significant difference between these four groups at a cut-off value 1.5 (p < 0.001) (Figure 1). Conclusion Patients with MI or CABG display clearly reduced segmental strain and SR values. However, in patients with chest-pain, segmental PLSR E seemed to be the only indicator revealing subtle differences between patients with no CAD or those assigned to PCI. The diagnostic value of PLSR E needs to be investigated in further studies. Abstract Table 1 Abstract Figure 1