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.