Incremental value of resting three-dimensional speckle-tracking echocardiography in detecting coronary artery disease

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• Coronary artery disease (CAD) often leads to early left ventricular (LV) dysfunction.
• Detecting subtle LV dysfunction in early-stage CAD is crucial for timely intervention.
• Traditional echocardiography may not always reveal early functional changes.

Purpose of the Study:

• To evaluate the added diagnostic value of resting three-dimensional speckle-tracking echocardiography (3D-STE) for early left ventricular dysfunction in patients with suspected CAD.
• To assess the efficacy of various strain parameters derived from 3D-STE in differentiating CAD patients from healthy individuals.

Main Methods:

• 110 patients with suspected CAD underwent resting 3D-STE and coronary artery angiography (CAG).
• 3D-STE software was used to measure peak longitudinal strain (LS), circumferential strain (CS), radial strain (RS), area strain (AS), and their time-to-peak values (T-LS, T-CS, T-RS, T-AS).
• Receiver operator characteristic (ROC) curve analysis was employed to determine the diagnostic performance of these parameters.

Main Results:

• ROC analysis revealed that T-LS and composite indices of strain and time-to-peak values had diagnostic value for early CAD detection (AUCs ranging from 0.621 to 0.692, P<0.005).
• The composite index of longitudinal strain showed the highest diagnostic performance, with 62% sensitivity and 76% specificity.
• These findings suggest that 3D-STE can identify subtle cardiac dysfunction in CAD patients.

Conclusions:

• Resting 3D-STE provides incremental value in the diagnosis of coronary artery disease.
• Specific strain parameters and their combinations derived from 3D-STE are effective in detecting early left ventricular dysfunction in CAD.
• 3D-STE is a promising tool for non-invasive assessment of cardiac function in patients with suspected CAD.