Association of postsystolic shortening on stress echocardiography and significant coronary artery stenosis: A single-centre retrospective cohort study

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2024-04-25 DOI:10.1111/cpf.12883

Joel Toftgård, Henrik Hedskog, Lars Rune, Jan Svedenhag, Gabriel Riva

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引用次数: 0

Abstract

Background

Postsystolic shortening (PSS) is one of the proposed quantitative measures to predict myocardial ischaemia in the stress echocardiographic (SE) evaluation. It is previously known that hypo-/akinesia (HA) correlates well with coronary stenosis. However, some patients undergoing SE only present with PSS, and their risk of significant coronary stenosis is less clear. This study aimed to evaluate the association between PSS and significant coronary stenosis compared with HA.

Methods

This was a retrospective cohort study at the hospital of S:t Görans, Stockholm, Sweden. All patients who underwent SE to investigate inducible ischaemia between 1 January 2018 and 15 October 2021 were eligible for inclusion. Exclusion criteria were normal SE and inconclusive test. Pathological SE were divided into two groups, patients with HA and those with PSS. Outcome was significant coronary artery stenosis visualized by invasive coronary angiography.

Results

The final study population consisted of 108 patients (73 PSS, 35 HA). The presence of HA was associated with a higher risk of significant stenosis compared to those with PSS (63% vs. 23%, p < 0.001). This relationship was observed among males (p < 0.001), but not among females (p = 0.133). Nonsignificant stenosis trended to be more common among patients with PSS (21% vs. 6%, p = 0.053)

Conclusions

The finding of PSS without HA was associated with a lower risk of significant coronary stenosis than HA. However, patients with PSS still often had nonsignificant coronary stenosis and PSS in the evaluation for nonobstructive coronary artery disease (CAD) should be further investigated.

Abstract Image

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负荷超声心动图收缩期后缩短与冠状动脉明显狭窄的关系：一项单中心回顾性队列研究。

背景收缩期缩短（PSS）是压力超声心动图（SE）评估中预测心肌缺血的量化指标之一。之前人们已经知道，收缩缩短（HA）与冠状动脉狭窄有很好的相关性。然而，一些接受 SE 检查的患者仅表现为 PSS，他们出现明显冠状动脉狭窄的风险并不明确。本研究旨在评估与 HA 相比，PSS 与明显冠状动脉狭窄之间的关系。方法这是瑞典斯德哥尔摩 S:t Görans 医院的一项回顾性队列研究。所有在 2018 年 1 月 1 日至 2021 年 10 月 15 日期间接受 SE 检查以调查诱发性缺血的患者均符合纳入条件。排除标准为 SE 正常和检测结果不确定。病理SE分为两组，即HA患者和PSS患者。结果最终研究对象包括 108 名患者（73 名 PSS，35 名 HA）。与 PSS 患者相比，HA 患者发生明显狭窄的风险更高（63% 对 23%，P < 0.001）。在男性中观察到了这种关系（p < 0.001），但在女性中没有观察到（p = 0.133）。无明显狭窄的趋势在 PSS 患者中更为常见（21% vs. 6%，p = 0.053）：与HA相比，发现无HA的PSS患者发生冠状动脉明显狭窄的风险较低。然而，PSS 患者仍常伴有非显著性冠状动脉狭窄，因此在评估非阻塞性冠状动脉疾病（CAD）时应进一步研究 PSS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.