Abstract
ObjectiveTwo-dimensional speckle tracking echocardiography (2D-STE) has been used as a diagnostic tool for coronary artery disease (CAD). However, whether vessel supplied myocardial strain and strain rate (SR) predict the severity of coronary artery stenosis in patients with CAD is unknown. This study aimed to investigate correlation of cardiac mechanical parameters in tissue speckle tracking measurements with coronary artery stenosis diagnosed by cardiac catheterization in patients with clinically diagnosed CAD.Methods and ResultsAmong 59 patients analyzed, 170 vessels were evaluated by coronary angiography and the corresponding echocardiography to quantify left ventricular myocardial strain and SR. The average longitudinal strain and SR of the segmental myocardium supplied by each coronary artery were calculated to achieve vessel myocardium strain (VMS) and strain rate (VMSR). The VMS and VMSR at each of four severity levels of stenosis showed significant differences among groups (p = 0.016, and p < 0.001, respectively). The strain and SR in vessels with very severe stenosis (≥75%, group IV; n = 29), 13.9 ± 4.3, and 0.9 ± 0.3, respectively, were significantly smaller than those of vessels with mild stenosis ≤ 25%, group I; n = 88, 16.9 ± 4.9, p = 0.023, and 1.2 ± 0.3, p = 0.001, respectively. The SR in vessels with moderate stenosis (26–49%, group II; n = 37), 1.0 ± 0.2, was significantly smaller than that in vessels with mild stenosis vessels (p = 0.021). The lower VMS and VMSR, the higher possibility of severe coronary stenosis is. The VMS and VMSR lower than 13.9 ± 4.3 and 0.9 ± 0.3, respectively predicted the severe coronary stenosis. The VMS and VMSR higher than 16.9 ± 4.9 and 1.2 ± 0.3, respectively predicted mild or no coronary artery stenosis.ConclusionsThe actual stenosis rate in catheterization demonstrates that this technique was able to assess coronary artery condition. Thus, the application of a non-invasive method of 2D-STE to evaluate and simplify diagnosis of CAD is feasible.
Highlights
It is widely known that cardiovascular disease (CVD) is a leading cause of mortality, and CVD has affected the economy worldwide
The average longitudinal strain and SR of the segmental myocardium supplied by each coronary artery were calculated to achieve vessel myocardium strain (VMS) and strain rate (VMSR)
170 vessels were evaluated by coronary angiography and 2D-Speckle tracking echocardiography (STE)
Summary
It is widely known that cardiovascular disease (CVD) is a leading cause of mortality, and CVD has affected the economy worldwide. Echocardiography is the most accessible and costeffective technique routinely used for these patients This noninvasive imaging model has been utilized visually across the spectrum of CAD [3]. To measure myocardial tissue velocity in the Doppler ultrasound system, a high-pass filter is implemented to exclude the low-frequency components from the vessel wall and the blood flow signal. This technique could lead to a potential loss of information from the lowvelocity flow [5, 6]. Two-dimensional speckle tracking echocardiography (2D-STE) has been determined to be a promising tool for LV functional assessment and can detect subclinical myocardial dysfunction early in the disease process [7, 8]. Experimental studies have demonstrated that the degree of postsystolic thickening and SR are suitable parameters for ischemia detection [11, 12]
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