Assessment of regional left ventricular myocardial strain in patients with left anterior descending coronary stenosis using computed tomography feature tracking

Abstract

Background: Computed tomography feature tracking (CT-FT) has emerged as a valuable method for the assessment of cardiac function. However, no studies have investigated the usefulness of CT-derived assessments of left ventricular (LV) strain in coronary artery disease (CAD). Our aim was to evaluate regional LV systolic deformation in patients with left anterior descending coronary artery (LAD) stenosis using CT-FT. Methods: Seventy-six patients with LAD stenosis were enrolled. The patients were divided into four groups according to the percentage of LAD stenosis: ≤25% was defined as group I (24 patients), 26 to 49% as group II (17 patients), 50 to 74% as group III (21 patients), and ≥ 75% as group IV (14 patients). Thirty-two sex-and age-matched healthy subjects were included as controls. Results: No intergroup differences were found between groups I-IV and the controls in terms of the left ventricular ejection fraction, end-diastolic volume and end-systolic volume. However, the longitudinal strain (LS) of the LAD territory was significantly reduced in groups I-IV compared with the controls (− 20.8, − 18.6%, − 18.6%, and − 17.0% vs − 23.7%, respectively). The circumferential strain (CS) of the LAD territory was significantly reduced in groups III and IV compared with the controls and groups I and II (− 22.4% and − 22.1% vs − 25.4, − 24.1%, and − 25.3%, respectively). Compared with the non-LAD territory, the LAD territory in groups II-IV showed significantly increased LS (− 18.6% vs − 21.9%, p = 0.07; − 18.6% vs − 21.9%, p = 0.024; − 17.5% vs − 20%, p = 0.032, respectively). The severity of LAD stenosis was positively correlated with the LS of the LAD territory (r = 0.438, p = 0.002). Conclusion: CT-FT can detect decreasing LV systolic function in patients with LAD stenosis. LV regional systolic deformation of the LAD territory was reduced with increasing LAD stenosis severity.

Predictive Model for Severe Coronary Artery Calcification in ESKD Patients

“…Upon conducting a multivariate regression analysis, age emerged as an independent risk factor for severe CAC, which is onsistent with previous research conducted at our centre 28 . Among the four main coronary branches, the LAD is the most commonly affected vessel in cardiovascular disease 29 , and exhibits the highest proportion of calcification, accounting for 67.21%. We have demonstrated that the factors influencing LAD calcification are comparable to those affecting the total CACS.…”

Quantifying left ventricular myocardial strain in patients with different CAD-RADS levels based on computed tomography feature tracking technology

“…Non-smokers were defined as having less than 100 lifetime cigarettes, and the rest of the patients were categorized as regular smokers. Patients who drank alcohol were defined as having a positive history of alcohol consumption 7 . Family history of CAD was defined as a confirmed diagnosis of CAD in an immediate family member.…”

“…Quantifying CACs can aid in the prediction of future cardiovascular disease, and an increased CACs is directly related to increased disease risk 2 . The value of myocardial strain for diagnosis and risk stratification has been demonstrated in various cardiovascular diseases, such as severe aortic stenosis 3 , aortic valve replacement 4 , 5 , adult congenital heart disease 6 , isolated left anterior descending coronary stenosis 7 , and myocardial infarction 8 .…”

Posicionamento do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia sobre o Uso do Strain Miocárdico na Rotina do Cardiologista – 2023

“…Observou-se uma redução do strain longitudinal nos segmentos do território da artéria descendente anterior, a despeito de volumes diastólico, sistólico e FE normais. 446 …”

“…Lower LS was observed in segments related to the anterior descending artery, despite normal diastolic and systolic volumes and EF. 446 …”