Multilayer longitudinal strain at rest may help to predict significant stenosis of the left anterior descending coronary artery in patients with suspected non-ST-elevation acute coronary syndrome

• Published in: International Journal of Cardiovascular Imaging 2016-12, Vol.32 (12), p.1675-1685
• Main Authors: Liu, Chong, Li, Jing, Ren, Min, Wang, Zhen-zhen, Li, Zi-yao, Gao, Fei, Tian, Jia-wei
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnostic imaging; Acute Coronary Syndrome - physiopathology; Aged; Area Under Curve; Cardiac Imaging; Cardiology; Chi-Square Distribution; Coronary Angiography; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - physiopathology; Echocardiography; Female; Humans; Image Interpretation, Computer-Assisted; Imaging; Logistic Models; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Original Paper; Predictive Value of Tests; Radiology; Reproducibility of Results; ROC Curve; Severity of Illness Index; Stress, Mechanical; Stroke Volume; Systole; Ventricular Function, Left
• ISSN: 1569-5794; 1573-0743; 1875-8312
• DOI: 10.1007/s10554-016-0959-0

Two-dimensional speckle tracking echocardiography (2D-STE) multilayer analysis of myocardial deformation is a non-invasive method that enables discrimination of transmural differences owing to myocardial ischemia or necrosis. We wished to ascertain if multilayer longitudinal strains at rest are associated with significant (≥70 %) stenosis of the left anterior descending coronary artery (LAD) in patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS). Our cohort comprised 113 consecutive patients with suspected NSTE-ACS and preserved ejection fraction (EF). Using coronary angiography, we diagnosed 63 patients with significant stenosis of the LAD and 50 patients without significant coronary artery disease. Echocardiography was done ≤48 h before angiography. Multilayer longitudinal strains were assessed from the endocardium, mid-myocardium and epicardium by 2D-STE. Regional longitudinal strain in LAD territory (RLS LAD ) was calculated as the mean peak systolic longitudinal strain of segments subtended by the LAD for all myocardial layers. Significant differences were observed in all strain parameters between the two groups. RLS LAD and global longitudinal strain in the endocardium showed higher accuracy than that in the mid-myocardium and epicardium, wall motion score index (WMSI), WMSI in LAD territory, and EF for detection of significant LAD stenosis (all P