The Role of 2-Dimensional Speckle Tracking Echocardiography in prediction of significant coronary artery

Abstract

Background:Speckle tracking echocardiography  is new technique  to  evaluate left  ventricular  function

Objective: To evaluate   sensitivity   and   specificity   of   two   dimension   global longitudinal strain ( 2D-GLS)    estimated by speckle tracking echocardiography (2D-STE)    to predict the   diagnosis and   degree of severity of CAD( coronary artery   disease) in patient   suspected to have stable ischemic     heart   diseases (IHD).

Patients and Methods: An observational cross-sectional study, patients underwent echocardiography (TTE), left ventricular (LV)systolic function were   estimate initially,   (calculate   LVEF)      then   assessment   of   LV   global   and   regional longitudinal  strain  (GLS)  were calculated  next.All  patient  underwent  coronary angiography in the catheterization unite and according to the result of coronary angiography, we separated patients  into two groups:  one how have  significant (≥70%) coronary arteries stenosis (group A),and another group   with non- significant(<70%) coronary arteries stenosis (group B). The study was done in echocardiography unit and catheterization lab in Ibn-Albitar center of cardiac surgery, the study carried out from April 2018 to May 2019.

Results: This   study 93 patients were included , there is  mean ages was (60.2 ±6.3) years, majority of cases were males (72.0%), 47.3% of all cases had ≥3 risk factors, and according to angiography study (67.7%) had significant CAD .The frequency of DM, dyslipidemia, and the occurrence of ≥3   risk factors were significantly   elevated   in     group A(patients  with  significant coronary  artery stenosis ) in comparison to the   group B. Mean EF and GLS were considerably lower in group A related to group B. There  was  not  much  difference  in  GLS  between  single  and  two  vessels involvement, however, the GLS value in three vessels was significantly lower compared to single and two vessels involvement. GLS were independent predictor of significant coronary artery stenosis, independent of the effect DM, dyslipidemia, and the presence of ≥3 concomitant risk factor.

Conclusion: Assessment (GLS) value by 2D speckle tracking echocardiography is good test for predicating diagnostic and severity of coronary arteries diseases, global longitudinal strain had positive relationship with increasing number of stenotic coronary arteries, and provides high quantitative diagnostic information for detection of the CAD.