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Ultrasonic Assessment of Myocardial Microstructure
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Global myocardial work in coronary artery disease patients without regional wall motion abnormality: Correlation with

Miao Li1, Yuhao Wang1, Lin Li1

  • 1Department of Cardiovascular Ultrasound, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

Clinical Cardiology
|November 28, 2023
PubMed

Insights

Global myocardial work efficiency (GWE) can detect severe coronary artery disease (CAD) in patients without wall motion abnormalities. This novel measure, global myocardial work (GMW), is superior to global longitudinal strain (GLS) for early CAD detection.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Early detection of coronary atherosclerotic diseases (CAD) without regional wall motion abnormality (RWMA) is crucial for improving cardiovascular outcomes.
  • Global myocardial work (GMW) parameters, including global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW), and global myocardial work efficiency (GWE), offer comprehensive quantitative assessment of myocardial function in CAD.

Purpose of the Study:

  • To investigate the incremental value of GMW in detecting CAD in patients without RWMA.
  • To assess if GMW parameters can predict the severity of coronary lesions.

Main Methods:

  • 124 patients referred for coronary angiography (CAG) without resting RWMA were enrolled.
  • Global longitudinal strain (GLS), GWI, GCW, GWW, and GWE were quantified.
  • Coronary lesion severity was evaluated by Gensini score (GS); patients were stratified into low, mid, and high GS subgroups.

Main Results:

  • CAD patients exhibited decreased GLS, GWE, GWI, GCW, and increased GWW compared to controls.
  • GWW increased in mid-GS group, while GLS, GWE, GWI, GCW decreased and GWW increased in high-GS group.
  • GWE was the most powerful predictor of high-GS, outperforming GLS, with GWE under 92.0% optimally identifying high-GS.

Conclusions:

  • Global myocardial work efficiency (GWE) is a potential predictive indicator for detecting severe coronary disease in non-RWMA CAD patients.
  • GWE demonstrated superior performance compared to conventional GLS in identifying severe coronary lesions.
Abstract

Keywords:
Gensini-scorecoronary artery diseaseglobal longitudinal strainmyocardial workpressure-strain loops

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