Left Ventricular Longitudinal Strain Detects Ischemic Dysfunction at Rest, Reflecting Significant Coronary Artery...

Area of Science:

• Cardiology
• Diagnostic Imaging
• Echocardiography

Background:

• The diagnostic utility of speckle-tracking echocardiography for stable coronary artery disease (CAD) is debated.
• Accurate non-invasive detection of significant CAD is crucial for patient management.

Purpose of the Study:

• To evaluate the diagnostic accuracy of global longitudinal strain (GLS) in predicting significant CAD.
• To assess GLS's ability to detect ischemic myocardial dysfunction.

Main Methods:

• Prospective study of 103 symptomatic patients undergoing coronary angiography.
• Resting echocardiography with GLS assessment performed before angiography.
• Exclusion of patients with acute coronary syndrome or prior CAD.

Main Results:

• Significant CAD (≥50% stenosis) was found in 45.6% of patients.
• Patients with significant CAD had lower GLS values (-15.73 ± 2.64%) compared to those without (-17.6 ± 1.85%).
• GLS > -16.3 showed 66% sensitivity and 73.2% specificity for significant CAD (AUC=0.692).
• Combined GLS analysis across coronary territories improved diagnostic accuracy (AUC=0.796).

Conclusions:

• Resting myocardial GLS is a valuable tool for detecting ischemic dysfunction.
• GLS accurately predicts significant stenosis in major coronary arteries.
• Speckle-tracking echocardiography offers a promising non-invasive approach for CAD assessment.