Detection of functionally significant coronary artery disease: Role of regional post systolic shortening

Rumbinaitė, Egle; Karužas, Arnas; Verikas, Dovydas; Kazakauskaitė, Eglė; Venckus, Vilius; Jakuška, Povilas; Benetis, Rimantas; Vaskelyte, J J

doi:10.4103/jcecho.jcecho_55_19

Cited by 6 publications

(5 citation statements)

References 27 publications

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Section: Discussionmentioning

confidence: 72%

“…However, PSS parameters did not differ significantly among CAD and non-CAD groups during the rest. 25 Contrary to the present study, their patients were ambulatory individuals without any evidence of acute ischemia. The mitral valve annular motion is representative of overall longitudinal LV contraction and relaxation, which is displayed by s′ and e′ velocities, respectively.…”

Section: Discussionmentioning

confidence: 72%

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The Association Between Postsystolic Index and SYNTAX Score in Hospitalized Patients With Non-ST-Elevation Acute Coronary Syndrome

Nabati

Golshani

Rahmani

et al. 2023

Journal of Diagnostic Medical Sonography

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Objective: Non-ST-elevation acute coronary syndrome (NSTE-ACS) is a heterogeneous disorder including subgroups with a low or high risk for myocardial ischemia. The presence of postsystolic index (PSI) is associated with myocardial ischemia. The focus of this study was to find probable association between PSI and severity of coronary artery disease (CAD) in a cohort of patients. Materials and Methods: This was a cross-sectional study that consisted of 83 patients with unstable angina, non-ST-segment myocardial infarction (UA/NSTEMI), and a left ventricular ejection fraction ≥50%, without visible regional wall motion abnormalities. All patients underwent echocardiography, and global longitudinal strain (GLS), PSI, and mitral annular peak systolic (s′) and early diastolic (e′) velocities were measured. Coronary angiography was then performed, and a SYNTAX score was calculated. Results: The patient cohort was divided into two groups based on their high and low SYNTAX scores. PSI and GLS were higher in those patients with a higher SYNTAX score than in individuals with a lower score (85.04% ± 67.02% vs 46.67 ± 39.03, P = .001 and −16.09 ± 3.70 vs −17.99 ± 2.87, P = .012, respectively). Among the different variables assessed, only PSI was an independent predictor of a high SYNTAX score ( B = 1.014, 95% confidence interval [CI]: 1.001–1.027, P = .034). Conclusion: This cohort study demonstrated that a cumulative PSI may be predictive of much more complex and extensive CAD, especially in patients with UA/NSTEMI.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 72%

The Association Between Postsystolic Index and SYNTAX Score in Hospitalized Patients With Non-ST-Elevation Acute Coronary Syndrome

Nabati

Golshani

Rahmani

et al. 2023

Journal of Diagnostic Medical Sonography

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“…Therefore, we were not able to correlate the extent of PSS with significant stenosis. In comparison, other studies (Bjork Ingul et al, 2007;Brainin et al, 2020;Celutkiene et al, 2012;Rumbinaite et al, 2020;Uusitalo et al, 2016;Voigt et al, 2003;Weidemann et al, 2006) have focused on the objective quantification of PSS. Some of these studies (Rumbinaite et al, 2020;Voigt et al, 2003;Weidemann et al, 2006) have presented PSS to be a sensitive parameter of CAD.…”

Section: The Visual Assessment Of Pssmentioning

confidence: 99%

“…In comparison, other studies (Bjork Ingul et al, 2007;Brainin et al, 2020;Celutkiene et al, 2012;Rumbinaite et al, 2020;Uusitalo et al, 2016;Voigt et al, 2003;Weidemann et al, 2006) have focused on the objective quantification of PSS. Some of these studies (Rumbinaite et al, 2020;Voigt et al, 2003;Weidemann et al, 2006) have presented PSS to be a sensitive parameter of CAD. Other authors (Brainin et al, 2020;Ishizu et al, 2011) have emphasized the high negative predictive value of PSS, which can be used to rule out significant CA stenosis.…”

Section: The Visual Assessment Of Pssmentioning

confidence: 99%

Association of postsystolic shortening on stress echocardiography and significant coronary artery stenosis: A single‐centre retrospective cohort study

Toftgård,

Hedskog,

Rune

et al. 2024

Clin Physio Funct Imaging

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BackgroundPostsystolic shortening (PSS) is one of the proposed quantitative measures to predict myocardial ischaemia in the stress echocardiographic (SE) evaluation. It is previously known that hypo‐/akinesia (HA) correlates well with coronary stenosis. However, some patients undergoing SE only present with PSS, and their risk of significant coronary stenosis is less clear. This study aimed to evaluate the association between PSS and significant coronary stenosis compared with HA.MethodsThis was a retrospective cohort study at the hospital of S:t Görans, Stockholm, Sweden. All patients who underwent SE to investigate inducible ischaemia between 1 January 2018 and 15 October 2021 were eligible for inclusion. Exclusion criteria were normal SE and inconclusive test. Pathological SE were divided into two groups, patients with HA and those with PSS. Outcome was significant coronary artery stenosis visualized by invasive coronary angiography.ResultsThe final study population consisted of 108 patients (73 PSS, 35 HA). The presence of HA was associated with a higher risk of significant stenosis compared to those with PSS (63% vs. 23%, p < 0.001). This relationship was observed among males (p < 0.001), but not among females (p = 0.133). Nonsignificant stenosis trended to be more common among patients with PSS (21% vs. 6%, p = 0.053)ConclusionsThe finding of PSS without HA was associated with a lower risk of significant coronary stenosis than HA. However, patients with PSS still often had nonsignificant coronary stenosis and PSS in the evaluation for nonobstructive coronary artery disease (CAD) should be further investigated.

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“…PSS is defined as a delayed systolic shortening occurring after the aortic valve closure. The most commonly used parameter to quantify PSS is the post-systolic index (PSI) which is calculated as [ 8 ]: where maximal strain and peak systolic strain indicate the peak negative strain in cardiac cycle and in systole, respectively.…”

Section: Introductionmentioning

confidence: 99%

Post-systolic shortening is superior to global longitudinal strain in predicting adverse events in patients with stable coronary artery disease and preserved systolic function

Zhang

et al. 2022

Insights Imaging

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Background Post-systolic shortening (PSS) is an important indicator for early identifying myocardial dysfunction. We aimed to investigate the predictive value of PSS assessed with speckle tracking automated functional imaging (AFI) on adverse events in patients with stable coronary artery disease (CAD) and preserved systolic function. Methods A total of 204 consecutive patients clinically diagnosed with stable CAD and left ventricular ejection fraction (LVEF) > 50% were included. Multiple parameters were analyzed with AFI technique. The composite endpoint included all-cause mortality, heart failure, myocardial infarction and stroke. Results During a median follow-up of 24 months (IQR 19–28 months), 30 patients (14.7%) reached the endpoint. Patients experiencing the endpoint had a lower absolute global longitudinal strain (GLS), a higher post-systolic index (PSI), and more left ventricle walls displaying PSS than patients without events. PSI (hazard ratio, 1.15; 95% CI, 1.04–1.27; p = 0.005) and per 1 increase in the number of left ventricle walls with PSS (hazard ratio 1.52, 95% CI 1.21–1.91, p < 0.000) were independent predictors of the endpoint, whereas GLS was not significantly associated with the endpoint after adjustment models. For patients with absolute value of GLS > 15.4%, a significant prognostic superiority was found in PSI compared with GLS (AUC = 0.73 [PSI] vs. 0.58 [GLS], p = 0.024). Conclusions PSS is an independent predictor for adverse events in stable CAD patients with preserved systolic function, and the prognostic value may be superior to GLS in patients with normal or mildly reduced GLS.

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Detection of functionally significant coronary artery disease: Role of regional post systolic shortening

Cited by 6 publications

References 27 publications

The Association Between Postsystolic Index and SYNTAX Score in Hospitalized Patients With Non-ST-Elevation Acute Coronary Syndrome

The Association Between Postsystolic Index and SYNTAX Score in Hospitalized Patients With Non-ST-Elevation Acute Coronary Syndrome

Association of postsystolic shortening on stress echocardiography and significant coronary artery stenosis: A single‐centre retrospective cohort study

Post-systolic shortening is superior to global longitudinal strain in predicting adverse events in patients with stable coronary artery disease and preserved systolic function

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