Accuracy of 2-dimensional speckle tracking echocardiography in diagnosis of coronary artery stenosis in stable angina pectoris.

Abstract

Background: It's difficult to detect the severity of coronary artery disease in the patients who have stable angina pectoris. Echocardiography is a well-validated non-invasive diagnostic tool for detecting myocardial ischaemia, but judging wall motion abnormalities is subjective. Conventional echocardiography can assess radial mechanics only, so it cannot assess the sensitive longitudinal mechanics. 2-Dimensional strain echocardiography is a recent tool that has the ability to solve these drawbacks.

Aim of study: To detect the accuracy of 2D-STE in prediction of significant coronary artery stenosis in the patients with stable angina pectoris.

Methods: This study included 70 patients who have stable angina pectoris. Conventional and 2D speckle tracking echocardiography were done to all patients then compared with the coronary angiography results. Patients were classified into three groups according to their coronary arteries affection; patients with normal Coronaries, non-obstructed lesion and patients with significant lesion.

Results: Our study results show that the mean GLS was (-18.67 ± 0.93) in normal cases, and it was (-15.82 ± 1.11) in non-obstructed lesions but GLS was (-13.19 ± 1.7) in patients with significant CAD. And the best cut-off point of GLS was reported as (-17.35%) with a sensitivity of 97.6% and specificity of 93.3%. Also we found that SLS results in significant lesions of LAD, LCX, RCA territory was (-16.3%, -15.95%, -17.45%) with sensitivity and specificity (87.8%, 93.3%), (70.7%, 93.3%), (82.9%, 93.3%) respectively.

Conclusion: Global longitudinal strain has a good diagnostic significance over visual evaluation during conventional echocardiogram in predicting significant stenosis of the coronary arteries in patients with stable coronary artery disease. Segmental Longitudinal strain is also a sensitive tool to detect the affected Coronary Territory.