Subtle echocardiographic markers of CAD: looking beyond the LV ejection fraction in stable angina patients.

IF 3.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Research in Cardiology Pub Date : 2024-10-16 DOI:10.1007/s00392-024-02561-9

Harshit Khare, Satyendra Tewari, Ankit Sahu, Prabhaker Mishra, Roopali Khanna, Sudeep Kumar, Naveen Garg, Aditya Kapoor

{"title":"Subtle echocardiographic markers of CAD: looking beyond the LV ejection fraction in stable angina patients.","authors":"Harshit Khare, Satyendra Tewari, Ankit Sahu, Prabhaker Mishra, Roopali Khanna, Sudeep Kumar, Naveen Garg, Aditya Kapoor","doi":"10.1007/s00392-024-02561-9","DOIUrl":null,"url":null,"abstract":"Background: A routine echocardiogram aims at identifying only regional wall motion abnormality (RWMA) or left ventricle diastolic dysfunction (LVDD) for coronary artery disease (CAD). When absent, a study is often labeled \"normal.\" This creates an unmet need to identify and add subtle markers of CAD to the routine echocardiogram to increase the diagnostic yield.Methods: Left ventricle (LV) systolic and diastolic parameters, along with left atrium (LA) strain parameters, were assessed using echocardiography in one hundred three patients of stable angina undergoing coronary angiography and compared with their SYNTAX score-II (SS-II).Results: The left ventricle global longitudinal strain (LV-GLS) and LA Volume indexed (LAVi) did not correlate significantly with the SS-II. The LA filling pressures reflected by the ratio of early mitral inflow velocity with early mitral annular velocity (E/e`), however, increased significantly with SS-II, with a cut-off value >10.39 for significant CAD (pvalue <0.001). The LA reservoir function parameters, peak atrial longitudinal strain (PALS), and peak global systolic strain rate (LAsSR) decreased significantly with increasing SS-II (p values of 0.011 and 0.001, respectively). The values < 23.56 for PALS and less than 1.15 for LAsSR, showed a significant association with CAD. The LA conduit function parameter, peak global early diastolic strain rate (LAeSR), also increased significantly with increasing SS-II (p-value <0.001), with values > 1.09 having a good correlation with CAD.Conclusion: Besides RWMA and LV-GLS, the LV diastolic and LA strain parameters can be potential echocardiographic markers for CAD in stable angina patients.","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Research in Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00392-024-02561-9","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: A routine echocardiogram aims at identifying only regional wall motion abnormality (RWMA) or left ventricle diastolic dysfunction (LVDD) for coronary artery disease (CAD). When absent, a study is often labeled "normal." This creates an unmet need to identify and add subtle markers of CAD to the routine echocardiogram to increase the diagnostic yield.

Methods: Left ventricle (LV) systolic and diastolic parameters, along with left atrium (LA) strain parameters, were assessed using echocardiography in one hundred three patients of stable angina undergoing coronary angiography and compared with their SYNTAX score-II (SS-II).

Results: The left ventricle global longitudinal strain (LV-GLS) and LA Volume indexed (LAVi) did not correlate significantly with the SS-II. The LA filling pressures reflected by the ratio of early mitral inflow velocity with early mitral annular velocity (E/e`), however, increased significantly with SS-II, with a cut-off value >10.39 for significant CAD (pvalue <0.001). The LA reservoir function parameters, peak atrial longitudinal strain (PALS), and peak global systolic strain rate (LAsSR) decreased significantly with increasing SS-II (p values of 0.011 and 0.001, respectively). The values < 23.56 for PALS and less than 1.15 for LAsSR, showed a significant association with CAD. The LA conduit function parameter, peak global early diastolic strain rate (LAeSR), also increased significantly with increasing SS-II (p-value <0.001), with values > 1.09 having a good correlation with CAD.

Conclusion: Besides RWMA and LV-GLS, the LV diastolic and LA strain parameters can be potential echocardiographic markers for CAD in stable angina patients.

查看原文本刊更多论文

心血管疾病的微妙超声心动图标记：超越稳定型心绞痛患者左心室射血分数的界限。

背景：常规超声心动图检查的目的仅在于识别冠状动脉疾病（CAD）的区域室壁运动异常（RWMA）或左室舒张功能障碍（LVDD）。如果没有，检查结果通常会被贴上 "正常 "的标签。这就需要在常规超声心动图中识别并添加细微的 CAD 标记，以提高诊断率：方法：对接受冠状动脉造影术的 103 名稳定型心绞痛患者使用超声心动图评估左心室收缩和舒张参数以及左心房应变参数，并与他们的 SYNTAX 评分-II（SS-II）进行比较：结果：左室整体纵向应变（LV-GLS）和LA容积指数（LAVi）与SS-II无明显相关性。然而，二尖瓣口早期血流速度与二尖瓣环早期血流速度之比（E/e`）所反映的 LA 充盈压随着 SS-II 的升高而明显升高，临界值大于 10.39 表示有明显的 CAD（pvalue 1.09），与 CAD 有很好的相关性：结论：除RWMA和LV-GLS外，左心室舒张应变和LA应变参数也可作为稳定型心绞痛患者CAD的潜在超声心动图标记。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Research in Cardiology 医学-心血管系统

CiteScore

11.40

自引率

4.00%

发文量

140

审稿时长

4-8 weeks

期刊介绍： Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.