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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Predictive value of speckle tracking technique for coronary artery stenosis in patients with coronary heart disease
Shiyang Qin1, Xuesong Cao1, Rui Zhang2
1Department of Ultrasound, Affiliated Hospital of Chengde Medical University Chengde 067000, Hebei, China.
Insights
Speckle tracking imaging (STI) effectively predicts coronary artery stenosis severity. Global longitudinal strain (GLS) and global area strain (GAS) show high accuracy in diagnosing coronary heart disease (CHD).
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Coronary artery stenosis (CAS) is a critical component of coronary heart disease (CHD).
- Accurate assessment of CAS severity is vital for patient management.
- Conventional ultrasound lacks sensitivity in detecting early-stage CAS.
Purpose of the Study:
- To evaluate the predictive capability of speckle tracking imaging (STI) for assessing the degree of coronary artery stenosis.
- To compare the diagnostic performance of STI-derived parameters with conventional echocardiography.
Main Methods:
- Retrospective analysis of 120 patients with diagnosed CAS and 63 controls with chest pain.
- Coronary Arteriography (CAG) and Gensini scoring for stenosis grading (mild, moderate, severe).
- Measurement of left ventricular global radial peak systolic strain (GRS), global longitudinal peak systolic strain (GLS), global area strain (GAS), and global circumferential peak systolic strain (GCS) using STI.
Main Results:
- STI parameters (GLS, GRS, GCS, GAS) were significantly lower in CAS patients compared to controls (P < 0.05).
- A significant inverse correlation was observed between stenosis severity and STI parameter values.
- Area under the curve (AUC) for diagnosing CAS ranged from 0.901 to 0.973, with GLS and GAS showing the highest diagnostic accuracy.
Conclusions:
- STI, particularly GLS and GAS, demonstrates high sensitivity and specificity for predicting coronary artery stenosis.
- STI offers superior predictive value for coronary artery stenosis compared to conventional ultrasound techniques.
- STI is a valuable non-invasive tool for assessing the severity of coronary artery stenosis in patients with CHD.
Objective:
To observe the predictive value of speckle tracking technique (STI) for the degree of coronary artery stenosis in patients with coronary heart disease (CHD).
Methods:
The clinical data of 120 patients with coronary artery stenosis admitted to Affiliated Hospital of Chengde Medical University from Feb. 2022 to Sep. 2022 was analyzed retrospectively. The other 63 patients who sought for medical help because of chest pain underwent Coronary Arteriography (CAG) examination during the same period but with Gensini score > 0 were selected as the control group. Coronary artery stenosis was divided into three subgroups according to the coronary Gensini score: mild, moderate, and severe stenosis. Routine ultrasound and STI techniques were performed in all patients. In addition, left ventricular global radial peak systolic strain (GRS), left ventricular global longitudinal peak systolic strain (GLS), left ventricular global peak systolic strain (GAS) and left ventricular global circumferential peak systolic strain (GCS) were measured and compared between the two groups and among the three subgroups.
Results:
There were no marked differences identified in conventional ultrasound parameters between the coronary artery stenosis group and control group, but the absolute values of GLS, GRS, GCS, and GAS were lower in the former group compared to control group; and the severe group had the lowest levels of above indexes, followed by moderate group, then mild group and control group (all P < 0.05). The results showed that the area under the curve (AUC) for GLS, GRS, GCS, and GAS in diagnosing coronary artery stenosis were 0.973, 0.933, 0.947, and 0.901, respectively. The AUCs of GLS, GRS, GCS, and GAS for the diagnosis of moderate/severe coronary artery stenosis were 0.968, 0.908, 0.901, and 0.942, respectively, with GAS and GLS assessed with the largest AUC values and higher sensitivity and specificity than other parameters.
Conclusion:
The global longitudinal strain of left ventricle obtained by STI technique was more sensitive to coronary artery stenosis than that by ultrasound technique, and it had a higher predictive value for coronary artery stenosis.
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