Ultrasound Evaluation of Left Ventricular Function in Coronary Artery Ectasia: The Added Value of 2D Speckle-tracking...

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• Coronary artery ectasia (CAE) involves abnormal coronary artery dilation and may be associated with subclinical myocardial dysfunction.
• Conventional echocardiography may fail to detect early left ventricular (LV) dysfunction in CAE.
• Two-dimensional speckle-tracking echocardiography (2D STE) shows potential for identifying subtle myocardial changes.

Purpose of the Study:

• To evaluate the efficacy of 2D STE in detecting subclinical left ventricular (LV) dysfunction in patients with coronary artery ectasia (CAE).
• To compare the diagnostic capabilities of 2D STE versus conventional echocardiography in assessing myocardial function in CAE.

Main Methods:

• A single-center observational study included 90 participants divided into controls (n=30), single-vessel CAE (n=30), and multi-vessel CAE (n=30).
• Standard echocardiographic indices (LVEF, volumes, diastolic function) and 2D STE-derived global strains (radial, longitudinal, circumferential, area) were assessed.
• Measurements were compared across groups using univariate and post-hoc analyses.

Main Results:

• Left ventricular ejection fraction (LVEF) was preserved in all groups.
• Conventional echocardiography identified abnormalities only in multi-vessel CAE.
• 2D STE revealed subclinical LV dysfunction in both single-vessel and multi-vessel CAE groups, with significantly reduced global longitudinal strain (GLS) in CAE cohorts compared to controls (p < 0.001).

Conclusions:

• 2D STE is effective in detecting subclinical left ventricular impairment in the early stages of coronary artery ectasia (CAE).
• Conventional echocardiographic methods are less sensitive and only detect dysfunction in advanced disease.
• 2D STE is valuable for the early monitoring of cardiac function in patients with CAE.