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Updated: Apr 14, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Prospective evaluation of speckle-tracking echocardiography for detecting functionally significant coronary artery
Jingru Lin1,2, Jili Long2,3, Min Ye1
1Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Insights
Speckle-tracking echocardiography (STE) shows basal longitudinal strain is linked to significant coronary artery disease (CAD), but its diagnostic value is similar to traditional measures. Further research may combine STE with other methods for better accuracy in diagnosing CAD.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Coronary artery disease (CAD) causes myocardial perfusion deficits and cardiac dysfunction.
- Quantitative flow ratio (QFR) assesses functional stenosis without invasive pressure measurements.
- Transthoracic echocardiography (TTE) and speckle-tracking echocardiography (STE) evaluate cardiac structure and function.
Purpose of the Study:
- To evaluate and compare the diagnostic value of TTE and STE in identifying functionally significant coronary stenosis.
- To determine if STE parameters can predict significant coronary artery disease.
Main Methods:
- 112 patients with suspected CAD underwent QFR assessment.
- Patients were grouped by QFR (≤0.8 or >0.8).
- TTE and STE were performed, followed by logistic regression and ROC curve analyses.
Main Results:
- Patients with significant stenosis (QFR ≤0.8) had higher interventricular septal thickness (IVS), posterior wall thickness, and left ventricular mass index (LVMI).
- Basal longitudinal strain (Basal LS) was significantly lower in the QFR ≤0.8 group.
- Basal LS, IVS, and LVMI showed comparable diagnostic performance for functionally significant CAD.
Conclusions:
- Basal LS is an independent predictor of significant CAD but has limited diagnostic efficacy.
- The diagnostic performance of Basal LS is comparable to structural echocardiographic parameters like IVS and LVMI.
- Combining STE with other modalities like myocardial contrast echocardiography may enhance diagnostic accuracy for CAD.
Background:
Functionally significant coronary artery disease (CAD) leads to myocardial perfusion deficits and cardiac dysfunction. Quantitative flow ratio (QFR) allows accurate assessment of functional stenosis without the need for pressure wire or adenosine. Traditional transthoracic echocardiography (TTE) and speckle-tracking echocardiography (STE) are commonly used to evaluate myocardial structure and function. This study aimed to evaluate and compare the diagnostic value of TTE and STE in identifying functionally significant coronary stenosis.
Methods:
A total of 112 hospitalized patients with suspected CAD underwent QFR assessment. Patients were divided into two groups based on QFR (QFR ≤0.8 and >0.8). TTE and STE were performed within 24 hours prior to coronary angiography. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic performance of echocardiographic parameters.
Results:
Compared to the QFR >0.8 group, patients in the QFR ≤0.8 group showed significantly higher interventricular septal thickness (IVS, P=0.007), posterior wall thickness (P=0.038), and left ventricular mass index (LVMI, P=0.006). Basal longitudinal strain (Basal LS) was significantly lower in the QFR ≤0.8 group (P=0.008). Multivariate logistic regression identified Basal LS as an independent predictor of functionally significant CAD [odds ratio (OR) =1.148, P=0.039]. ROC analysis revealed comparable diagnostic performance for Basal LS [area under the curve (AUC) =0.634, P=0.016], IVS (AUC =0.653, P=0.005), and LVMI (AUC =0.683, P=0.001), with no statistically significant difference among them (all P>0.05).
Conclusions:
Basal LS is independently associated with functionally significant CAD. However, its diagnostic efficacy is limited and comparable to structural parameters such as IVS and LVMI. Combining STE with other imaging modalities, such as myocardial contrast echocardiography, may improve diagnostic accuracy.
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