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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
09:05

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

Published on: October 20, 2016

Incremental value of subclinical left ventricular systolic dysfunction for the identification of patients with

Gaetano Nucifora1, Joanne D Schuijf, Victoria Delgado

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

American Heart Journal
|January 28, 2010
PubMed

Insights

Global longitudinal strain (GLS) impairment helps detect obstructive coronary artery disease (CAD) in patients without overt systolic dysfunction. This echocardiographic marker improves upon traditional risk scores for identifying significant blockages.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Left ventricular (LV) diastolic and subclinical systolic dysfunction are potential markers for coronary artery disease (CAD).
  • The predictive value of these markers for obstructive CAD was previously unknown.

Purpose of the Study:

  • To investigate the utility of echocardiographic parameters, including global longitudinal strain (GLS), in predicting obstructive CAD.
  • To assess the association between LV diastolic dysfunction, GLS, and obstructive CAD in patients without known CAD.

Main Methods:

  • 182 outpatients without known CAD underwent 64-slice multislice computed tomography (MSCT) coronary angiography and echocardiography.
  • Speckle-tracking echocardiography was used to assess LV systolic (GLS) and diastolic function.
  • Duke Clinical Score was used to determine pretest likelihood of obstructive CAD.

Main Results:

  • Obstructive CAD was identified in 35% of patients by MSCT.
  • Diastolic dysfunction (OR 3.72) and impaired GLS (OR 1.97) were significantly associated with obstructive CAD.
  • A GLS cutoff of > or =-17.4 demonstrated high sensitivity (83%) and specificity (77%) for detecting obstructive CAD, offering incremental value over clinical scores and diastolic function.

Conclusions:

  • Impaired global longitudinal strain (GLS) is a valuable tool for detecting obstructive coronary artery disease (CAD) in patients lacking overt left ventricular systolic dysfunction.
  • Echocardiographic assessment of GLS can aid in the early identification of significant CAD, complementing traditional risk stratification methods.
Abstract

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