SIGNIFICANCE OF LONGITUDINAL SPECKLE STRAIN AND ITS CORELATIONS WITH CORONARY ANGIOGRAPHY IN CORONARY ARTERY DISEASE

Abstract

Background: Significant coronary artery stenosis might cause persistently impaired longitudinal left ventricle  function at rest. LV global longitudinal strain (GLS) can be accurately assessed by 2D speckle-tracking strain echocardiography (2D-STE) in correlation with coronary angiogram (CAG). Objective: We aimed to evaluate the diagnostic accuracy of LV global longitudinal strain obtained by 2D-STE in the prediction of the severity of coronary artery disease (CAD) in acute coronary syndrome. Methods:  100   patients   with   the   acute   coronary   syndrome   were   included.   They   underwent transthoracic   echocardiography   (TTE)   to   measure   GLS   and   they   also   underwent   coronary angiography (CA). Images were obtained in the apical long-axis, four-chamber, and two chamber views. The regional longitudinal systolic strain was measured in 17 myocardial segments and averaged to provide global longitudinal strain (GLS). This GLS was co-related to the severity of coronary artery disease. Results: There was a significant decrease in GLS in patients with the significant coronary artery disease as compared to a patient with non-significant coronary artery disease. The GLS in patient with non-significant coronary artery disease was -22.34±0.32. The value of GLS in single-vessel CAD, double vessel CAD and triple vessel CAD being -18.88±1.07, -17.33±0.8, -15.33±0.45 respectively. The GLS cut off valve was found to be -18.46+3.18 (p=<0.001).The sensitivity of GLS in SVD, DVD, TVD was 96.88%, 85% and 88.46% respectively and specificity was 81.29%,70.1% and 69.81% respectively. There was a significant positive correlation between GLS and the severity of coronary artery disease which was seen as incremental significant decrease in GLS with an increasing number of coronary vessels involved. Conclusion:  Measurement   of   global   longitudinal   strain   using   2D   speckle   tracking echocardiography is a sensitive and accurate tool in the prediction of severity CAD in acute coronary syndromes.