Two-dimensional strain technique to detect the function of coronary collateral circulation.

Area of Science:

• Cardiovascular imaging
• Myocardial mechanics
• Coronary artery disease

Background:

• Coronary collateral circulation (CCC) plays a crucial role in mitigating ischemia.
• Evaluating CCC function in ischemic myocardium is essential for patient management.

Purpose of the Study:

• To assess the functional contribution of CCC in ischemic myocardium using a two-dimensional strain technique.
• To determine if two-dimensional strain can predict the presence and functional impact of CCC.

Main Methods:

• Utilized two-dimensional strain echocardiography to analyze myocardial segments.
• Segments were categorized into no CCC (NCCC), CCC, and normal control groups.
• Measured longitudinal, radial, and circumferential strain/strain rate, plus left ventricular rotation and rotation rate.

Main Results:

• Patients with CCC demonstrated significantly enhanced systolic and diastolic strain/strain rate parameters compared to NCCC.
• Time to peak strain and strain rate was delayed in the NCCC group, indicating mechanical dyssynchrony.
• Late diastolic strain rate in the circumferential direction showed predictive value for CCC presence via ROC analysis.

Conclusions:

• CCC effectively preserves regional myocardial function in ischemic territories.
• The two-dimensional strain technique is a practical, noninvasive tool for assessing CCC and its functional significance.