Two-Dimensional Speckle Tracking During Dobutamine Stress Echocardiography Versus Myocardial Perfusion Imaging by Single Photon Emission Computed Tomography in Patients With Suspected Coronary Artery Disease

Background

Coronary artery disease (CAD) is one of the causes of morbidity and death worldwide. Recently, speckle tracking technologies allowed the assessment of the strain of each myocardial segment in an automated method that may decrease inter-operator variability.

Objective

To compare the effectiveness of two-dimensional speckle tracking global longitudinal strain (GLS) during dobutamine stress echocardiography (DSE) with myocardial perfusion imaging (MPI) using single photon emission computed tomography (MPI SPECT) in the diagnosis of CAD.

Methods

A cross-sectional study was conducted involving 103 patients with CAD suspicion. Each participant underwent MPI SPECT and GLS measurements at rest and during peak dobutamine stress. The outcomes from GLS-DSE and MPI SPECT were then compared against the results of ICA as the reference standard for diagnosis.

Results

The mean age of included patients was 57.79 ± 8.08 years. The MPI-SPECT defect size results demonstrated a highly significant (p value < 0.001) and strong positive correlation with the number of affected vessels in invasive coronary angiography (ICA). The sensitivity and specificity of the MPI SPECT were 90.62% and 92.96%, respectively, with a PPV of 85.29% and an NPV of 95.65%. Additionally, a highly significant (p value < 0.001) and strong negative correlation was observed between GLS values at peak DSE and the number of affected vessels in ICA. GLS at peak DSE had 78.12% sensitivity and 88.73% specificity with PPV 75.76% and NPV 90%.

Conclusion

GLS at peak DSE looks to be another noninvasive tool for the assessment of patients with suspected CAD, with the benefits of being a quick, non-expensive, and radiation-free test.