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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Two-Dimensional Speckle Tracking Echocardiography Identifies Coronary Artery Disease in 690 Patients: A Retrospective
Huolan Zhu1,2, Chenguang Yang1, Yi Li1,3
1Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland).
Insights
Two-dimensional speckle tracking echocardiography (2D-STE) effectively identifies myocardial ischemia in coronary artery disease (CAD) patients. This non-invasive technique shows promise for early CAD screening when combined with ECG monitoring.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Coronary artery disease (CAD) diagnosis relies on invasive methods.
- Two-dimensional speckle tracking echocardiography (2D-STE) is an emerging non-invasive diagnostic tool.
- Identifying myocardial ischemia in CAD patients is crucial for timely intervention.
Purpose of the Study:
- To evaluate the efficacy of 2D-STE in detecting myocardial ischemia in patients with diagnosed CAD.
- To assess the diagnostic performance of global longitudinal peak strain (GLPS) in different myocardial layers.
Main Methods:
- A retrospective study involving 690 patients undergoing angiography.
- 346 patients diagnosed with CAD (≥50% stenosis in a major coronary artery).
- 2D-STE analysis performed using EchoPAC software.
Main Results:
- Global strain was significantly impaired in CAD patients (P<0.01).
- GLPS analysis in epicardial, middle, and endocardial layers showed significant associations with CAD.
- Optimal cut-off values, AUCs, sensitivities, and specificities were determined for each layer.
Conclusions:
- 2D-STE demonstrates clinical utility for identifying myocardial ischemia in CAD patients.
- The findings support the use of 2D-STE in clinical practice for suspected CAD.
- Combined 2D-STE and ECG monitoring may facilitate early CAD screening.
Abstract:
BACKGROUND Two-dimensional speckle tracking echocardiography (2D-STE) is a novel and non-invasive technique for the diagnosis of coronary artery disease (CAD). This retrospective study from a single center aimed to identify myocardial ischemia using 2D-STE in CAD patients identified by angiography. MATERIAL AND METHODS From March 1 to November 30, 2019, 690 patients in Beijing Hospital were enrolled. After angiography, 346 patients were diagnosed with CAD. Reduction in vessel diameter of ≥50% by stenosis in at least 1 major coronary artery or its main branch was considered CAD. Analysis of 2D-STE was performed using EchoPAC version 201. RESULTS The global strain was significantly impaired in CAD patients (P<0.01). Global longitudinal peak strain (GLPS) was analyzed in layers. For GLPS of the epicardium, the odds ratio (OR) was 1.297 (1.217-1.382; P=0.002), the area under the curve (AUC) was 0.727, and the cut-off value was -16.95; sensitivity and specificity were 73.7% and 63.0%, respectively. For GLPS of the middle layer, the OR was 1.260 (1.192-1.333; P<0.001), the AUC was 0.732, and the cut-off value was -20.95; sensitivity and specificity were 82.4% and 56.2%, respectively. For GLPS of the endocardium, the OR was 1.193 (1.137-1.251; P<0.001), the AUC was 0.708, and the cut-off value was -22.95; sensitivity and specificity were 82.9% and 52.9%, respectively. CONCLUSIONS The findings from this study support the clinical application of 2D-STE in patient populations with suspected myocardial ischemia due to CAD. Therefore, 2D-STE combined with ECG monitoring may have a future role for early screening of CAD patients.
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