Non-invasive left ventricular pressure-strain loop in predicting coronary artery occlusion in patients with non-ST
Yao Huang1, Lingping Huang1, Guangrui Feng2
1Department of Ultrasound, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Hubei, 437000, China.
Insights
Non-invasive left ventricular pressure-strain loop (LV-PSL) analysis, particularly global work index (GWI), effectively predicts coronary artery occlusion in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients, improving diagnostic accuracy.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Biomedical Engineering
Background:
- Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) requires accurate diagnosis of coronary artery occlusion.
- Traditional diagnostic methods can be invasive or lack comprehensive functional assessment.
- Left ventricular pressure-strain loop (LV-PSL) analysis offers a non-invasive approach to assess cardiac mechanics.
Purpose of the Study:
- To evaluate the predictive capability of non-invasive LV-PSL analysis and myocardial work parameters for coronary artery occlusion in NSTE-ACS patients.
- To compare the diagnostic performance of different myocardial work parameters against left ventricular global longitudinal strain (GLS).
- To determine if combining GLS with myocardial work parameters enhances diagnostic efficacy.
Main Methods:
- A cohort of 113 patients with suspected NSTE-ACS underwent LV-PSL analysis prior to coronary angiography.
- Myocardial work parameters including global work index (GWI), global constructive work (GCW), global wasted work (GWW), and work efficiency (GWE) were calculated.
- Patients were categorized into occluded (26) and non-occluded (65) coronary artery groups based on angiography results.
Main Results:
- The occluded group showed significantly higher GWI, GCW, and GWE, and lower GLS and GWW compared to the non-occluded group (P < 0.05).
- Global work index (GWI) demonstrated superior area under the curve (AUC) for detecting coronary occlusion compared to GLS, GCW, GWW, and GWE.
- Combining GLS with myocardial work parameters significantly improved diagnostic efficacy (P = 0.016).
Conclusions:
- LV-PSL analysis, especially focusing on GWI, is a highly effective non-invasive tool for detecting coronary artery occlusion in NSTE-ACS.
- This method aids in early intervention and enhances diagnostic accuracy for NSTE-ACS patients.
- Myocardial work parameters provide valuable insights into cardiac function beyond traditional strain analysis.
Abstract:
This cohort study aims to evaluate the capability of non-invasive left ventricular pressure-strain loop (LV-PSL) analysis using myocardial work parameters to predict coronary artery occlusion in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). A total of 113 patients suspected of having NSTE-ACS underwent PSL analysis prior to coronary angiography to obtain myocardial work parameters such as global work index (GWI), global constructive work (GCW), global wasted work (GWW), and work efficiency (GWE). Based on the results of coronary angiography, patients were categorized into two groups: non-occluded (65 cases) and occluded (26 cases). The study compared differences in left ventricular global longitudinal strain (GLS) and myocardial work parameters between the groups and assessed the predictive value of these parameters for diagnosing coronary artery occlusion. The occluded group exhibited significantly higher GWI, GCW, and GWE values and lower GLS and GWW values (P < 0.05). The area under the curve (AUC) for detecting coronary occlusion was superior for GWI compared to GLS, GCW, GWW, and GWE. Additionally, combining GLS with myocardial work parameters improved diagnostic efficacy (P = 0.016). GWI-focused LV-PSL analysis more effectively detects coronary occlusion in NSTE-ACS, guiding early intervention and improving diagnostic accuracy.
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