Using Two-Dimensional Speckle Tracking Echocardiography to Predict Coronary Artery Disease Severity in Patients with Chronic Stable Angina

Document Type : Original Article

Authors

Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: In patients with stable angina pectoris [SAP], conventional echocardiography at rest gives minimal information regarding coronary artery disease [CAD]. Even in patients with severe CAD, left ventricle [LV] wall motion at rest may be normal. As a result, it would be beneficial if another resting parameter could aid to distinguish patients with severe CAD from those with milder or no CAD. 2D strain echocardiography can anticipate the degree of coronary lesions.
Aim of the work: The goal of this study was to study the relationship between LV systolic deformation and the severity of CAD in individuals with SAP using 2D STE.
Patients and Methods: This study included [120] SAP patients, who were divided into three groups according to coronary angiography: Group [A] consists of [12] patients whose coronary angiography is normal Group [B]: [40] patients with low SS < 22. Group [C]: [48] patients with SS ≥ 22. All patients were undergoing Echocardiography [conventional and STE for assessment of global and circumferential strain.
Results: There is a statistically significant correlation between the number of vessels affected and GLS and GCS. There is a significant correlation between SS and GLS [P=0.001] which is weak significant in group B and lost in group C. GLS can predict high SS with a cut-off value of ≤-15, with a sensitivity of 85% and specificity of 87.5%, also GCS can predict high SS with a cut-off value ≤-18, with a sensitivity of 75% and specificity of 83.3%.
Conclusion: 2D STE using GLS can diagnose ischemia with a cut-off value of ≤-19 and predict lesion severity with a cut-off value of ≤-15; also, GCS can diagnose ischemia with a cut-off value ≤ -23 and predict lesion severity with cut-off value ≤-18.

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