Layer‐specific global longitudinal strain reveals impaired cardiac function in patients with reversible ischemia

• Published in: Echocardiography (Mount Kisco, N.Y.) N.Y.), 2018-05, Vol.35 (5), p.632-642
• Main Authors: Hagemann, Christoffer E., Hoffmann, Søren, Olsen, Flemming J., Jørgensen, Peter G., Fritz‐Hansen, Thomas, Jensen, Jan S., Biering‐Sørensen, Tor
• Format: Article
• Language: English
• Subjects: coronary artery disease; echocardiography; myocardial strain
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.13830

Aims Two‐dimensional speckle tracking echocardiography (2DSTE) detects early signs of left ventricular dysfunction; however, it is unknown whether layer‐specific global longitudinal strain (GLS) has incremental value in diagnosis of patients with reversible ischemia assessed by single photon emission computed tomography (SPECT). Methods and Results Eighty patients with stable angina pectoris (SAP), normal left ventricular ejection fraction (LVEF), and no history of ischemic heart disease were retrospectively identified to have been examined by 2DSTE, SPECT, and coronary angiography (CAG). Patients with a normal SPECT constituted the control group, and patients with a positive SPECT were divided into patients with or without (true‐ or false‐ positive SPECT) significant stenosis assessed by CAG. GLS was measured for two myocardial layers (endocardial and epicardial) and as well as mid‐myocardial GLS. Patients with reversible ischemia had significantly lower GLS compared to the control group (GLSEndocardial: −19.0 ± 4.4% vs −21.4 ± 3.7%, P = .011; GLSEpicardial: −14.3 ± 2.9% vs −16.3 ± 2.9%, P = .004); GLSMid‐myocardial: −16.5 ± 3.6% vs −18.6 ± 3.2%, P = .006. This difference was even more evident in patients with a true‐positive SPECT (GLSEndocardial: −18.0 ± 4.4% vs −21.4 ± 3.7%, P