The additional utility of two‐dimensional strain in detection of coronary artery disease presence and localization in patients undergoing dobutamine stress echocardiogram

Roushdy, Alaa; Seoud, Yomna Abou el; Elrahman, Mohamed Abd; Wadeaa, Basem; El-Etriby, Adel; Salam, Zainab Abd el

doi:10.1111/echo.13569

Cited by 10 publications

(18 citation statements)

References 33 publications

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“…In our study, 76.1% subjects had significant CAD which cor- fer between these groups. 7,8,13 Median GLS also varied significantly among subjects without significant CAD and subjects with SVD, DVD, or TVD in our study. It is similar to the results found with mean GLS in the study by Moustafa et al 10…”

Section: Baseline Characteristicssupporting

confidence: 58%

“…Roushdy et al reported a moderate agreement with GLS at peak stress (κ = 0.499, P < .001). 8 The agreement between territorial strain and CAG in detecting LAD disease was substantial while it was moderate for LCX disease and fair for RCA lesions. The finding with 2D-strain at peak stress in the study by Roushdy et al was similar with good agreement in LAD territory (κ = 0.775, P<.001) but fair agreement in LCX territory (κ = 0.263, P<.01) and moderate agreement in RCA territory (κ = 0.415, P < .001).…”

Section: Agreement Of Dse and Strain Imaging With Cagmentioning

confidence: 91%

“…19 Another causative factor can be the anatomic variation regarding dominance of RCA or LCX or codominance. 8 The agreement between strain imaging and CAG for detecting number of vessels diseased was moderate. Roushdy et al noted the similar finding with 2D-strain at peak stress (κ = 0.579, P < .001 significant CAD, involvement of LAD territory and number of vessels affected.…”

Section: Agreement Of Dse and Strain Imaging With Cagmentioning

confidence: 98%

“…This was in agreement with the study by Roushdy et al (−16.75, sensitivity 77% and specificity 83%) and systematic review by Norum et al (−17.2) which involved four electronic databases. 8,18 This can be attributed to the sub-endocardial location of longitudinal myocardial fibers which makes them more susceptible to ischemic changes. 13 This makes GLS a highly sensitive and specific marker of CAD.…”

Section: Roc Analysismentioning

confidence: 99%

“…The finding with 2D-strain at peak stress in the study by Roushdy et al was similar with good agreement in LAD territory (κ = 0.775, P<.001) but fair agreement in LCX territory (κ = 0.263, P<.01) and moderate agreement in RCA territory (κ = 0.415, P < .001). 8 The reduced agreement in posterior-lateral circulation can be attributed to problems with image quality in the inferior, lateral, and posterior walls. 19 Another causative factor can be the anatomic variation regarding dominance of RCA or LCX or codominance.…”

Section: Agreement Of Dse and Strain Imaging With Cagmentioning

confidence: 99%

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Utility of global longitudinal strain to detect significant coronary artery disease, its extent and severity in patients with stable ischemic heart disease

et al. 2020

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Background: Early changes in cardiac function due to ischemia may be detected by global longitudinal peak systolic strain (GLS). Till date, no Indian data exist regarding role of GLS in stable ischemic heart disease (SIHD) and data showing correlation of GLS and SYNTAX score (SS) is meager in world literature. Our aim was to ascertain the role of GLS in SIHD. Methods: One hundred and seventeen subjects with angina and normal transthoracic echocardiogram (TTE) underwent strain echocardiography and coronary angiography (CAG). Results: There was significant correlation between GLS and SS values (R 2 = .686, P < .0001). The correlation was weaker yet significant in the low SS (<22) group (R 2 = .491, P < .0001) and high SS (≥22) group (R 2 = .602, P < .0001). The cutoff value of GLS to detect significant CAD was −16.5 (87.6% sensitivity, 85.7% specificity, P < .0001), to predict high SS was −13.5% (sensitivity 78.3%, specificity 87.9%, P < .0001) and to predict triple vessel disease (TVD) was −14.5 (95.7% sensitivity, 73.4% specificity, P < .0001). The agreement between GLS and CAG for detection of significant CAD was substantial (κ = 0. 676, P < .0001), similar to that between territorial strain and CAG in detecting LAD disease (κ = 0.688, P < .0001) while agreement between strain imaging and CAG for detecting number of vessels diseased was moderate (κ = 0.406, P < .0001). Conclusion: Global longitudinal peak systolic strain must be conducted on subjects with angina and inconclusive electrocardiogram (ECG) findings to rule out significant CAD even if conventional TTE was normal. This may facilitate early diagnosis of CAD or sub-clinical left ventricular systolic dysfunction (LVSD), preventive or treatment measures, and overall cost savings.

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Section: Baseline Characteristicssupporting

confidence: 58%

Section: Agreement Of Dse and Strain Imaging With Cagmentioning

confidence: 91%

Section: Agreement Of Dse and Strain Imaging With Cagmentioning

confidence: 98%

Section: Roc Analysismentioning

confidence: 99%

Section: Agreement Of Dse and Strain Imaging With Cagmentioning

confidence: 99%

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Utility of global longitudinal strain to detect significant coronary artery disease, its extent and severity in patients with stable ischemic heart disease

et al. 2020

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Accuracy of global and regional longitudinal strain at peak of dobutamine stress echocardiography to detect significant coronary artery disease

Ilardi

Santoro

Maréchal

et al. 2021

Int J Cardiovasc Imaging

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Dobutamine stress echocardiography (DSE) is sensitive but subjective diagnostic tool to detect inducible ischemia. Nowadays, speckle tracking allows an objective quantification of regional wall function. We aimed to investigate the feasibility and accuracy of global (GLS) and regional longitudinal strain (RLS) during DSE to detect significant coronary stenosis (SCS). We conducted a prospective observational multicenter study including patients undergoing DSE for suspected SCS. 50 patients with positive DSE underwent coronary angiography. Besides visual regional wall motion score index (WMSI), GLS and RLS were determined at rest and at peak stress by Automated Function Imaging. DSE GLS feasibility was 96%. Among 35 patients with SCS, 12 patients were affected by multivessel disease, 18 had stenosis of left anterior descending artery (LAD), 18 of left circumflex (LCX) and 15 of right coronary artery (RCA). At peak stress, both GLS reduction (p = 0.037) and WMSI worsening (p = 0.04) showed significant agreement with coronary angiography for detecting SCS. When single lesion was considered, peak stress GLS and LAD RLS were lower in the obstructed LAD regions than in normo-perfused territories (17.4 ± 5.5 vs. 20.5 ± 4.4%, p = 0.03; 17.1 ± 7.6 vs. 21.6 ± 5.5%, p < 0.02, respectively). Furthermore, the addition of RLS to regional WMSI was able to improve accuracy in LAD SCS prediction (AUC 0.68, p = 0.037). Conversely, in presence of LCX or RCA SCS, LS was less accurate than WMSI at peak stress. In conclusion, DSE strain analysis is feasible and may improve prediction of LAD SCS, whereas regional WMSI assessment performs better in presence of SCS of LCX and RCA.

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The Evolution of Ischemia Detection with Echocardiography

Ooi

Chapman

Iyngkaran

et al. 2020

Curr Cardiovasc Imaging Rep

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The additional utility of two‐dimensional strain in detection of coronary artery disease presence and localization in patients undergoing dobutamine stress echocardiogram

Cited by 10 publications

References 33 publications

Utility of global longitudinal strain to detect significant coronary artery disease, its extent and severity in patients with stable ischemic heart disease

Utility of global longitudinal strain to detect significant coronary artery disease, its extent and severity in patients with stable ischemic heart disease

Accuracy of global and regional longitudinal strain at peak of dobutamine stress echocardiography to detect significant coronary artery disease

The Evolution of Ischemia Detection with Echocardiography

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