Transthoracic ultrasonic tissue indices identify patients with severe left anterior descending artery stenosis. Correlation with fractional flow reserve. Pilot study

Abstract

A b s t r a c t Background and aim:The aim of this study was to evaluate the potential clinical application of ultrasonic tissue indices, with a focus on systolic strain (SS) and systolic strain rate (SSR) parameters derived from transthoracic echocardiography, in the assessment of left anterior descending artery (LAD) stenosis. Methods:The data of 30 patients with significant LAD stenosis were analysed. All patients underwent transthoracic echocardiography to obtain systolic myocardial velocity (Sm), longitudinal SS, and SSR from basal, mid, and apical segments of anterior and inferior walls in two-chamber apical view. Severity of LAD obstruction was measured by means of fractional flow reserve (FFR) during coronary catheterisation.Results: Systolic velocities, strain, and strain rate measured in basal, middle, and apical segments of the anterior left ventricular (LV) wall were lower when compared to those obtained from the corresponding, i.e. unaffected, inferior LV wall. There was a significant correlation between FFR and the value of SS, SSR characterising the apical LV segment of the anterior wall (r = -0.583, p = 0.01; r = -0.598, p = 0.01, respectively). Moreover, we found significant correlation between FFR and Sm in the mid-segment of the LV anterior wall (r = 0.611, p = 0.009). Conclusions:We conclude that SS and SSR obtained from the apical segment of the anterior LV wall may be related to the severity of LAD stenosis.

Regional Myocardial Work Measured by Echocardiography for the Detection of Myocardial Ischemic Segments: A Comparative Study With Invasive Fractional Flow Reserve

“…Regional myocardial dysfunction caused by coronary stenosis can be detected by two-dimensional speckle tracking echocardiography ( 3 , 4 ). In stable patients, the longitudinal strain is useful for the detection of functionally significant CADs, which has been confirmed by invasive FFR ( 5 – 7 ). However, because of the load-dependent nature of myocardial strain, the interpretation of the myocardial functional status based on strain analysis has to be made in a context of ventricular loading conditions ( 8 ).…”

Myocardial deformation indices for detection of the functional significance of intermediate left anterior descending coronary artery stenosis: FFR guided study

“…The researchers found that the patients with significant CAD had significantly reduced rest GLS, but not LVEF or end-diastolic volume, compared to those with non-obstructive CAD. Dobrowolski et al [15] evaluated 30 patients with significant LAD stenosis confirmed by FFR values ≤ 0.8. The study compared anterior and inferior walls in the two-chamber apical view in the same group of patients.…”

“…Dobrowolski et al [ 15 ] evaluated 30 patients with significant LAD stenosis confirmed by FFR values ≤ 0.8. The study compared anterior and inferior walls in the two-chamber apical view in the same group of patients.…”

“…15). The least absolute value of these 7 segments was adopted as the regional PLS, and its curve was used as a reference for the calculation of PSI and the duration between AVC and regional PLS [ 15 ].…”