Correlation between global longitudinal strain determined by speckle tracking echocardiography and severity of coronary artery disease

Introduction: Measurements of longitudinal motion and deformation are sensitive markers of coronary artery disease (CAD). Ejection fraction (EF) reduction is a relatively delayed stage in myocardial dysfunction, when there is enough myocardial damage. Thus, de-tecting myocardial dysfunction at an early subclinical stage can have diagnostic, therapeutic and prognostic significance.

Objective: In this study we aimed to evaluate the corre-lation between 2D speckle tracking echocardiography global longitudinal strain (GLS) and severity of coro-nary artery disease (CAD).

Methods: The study was performed in the Cardiology Department on 98 consecutive patients with typical symptoms of angina pectoris. Transthoracic echocar-diography and coronary angiography were performed in all patients. Measurements of global and segmental longitudinal peak systolic strain were taken following exclusion criteria: age <18 years, overt heart failure and left ventricular systolic dysfunction (ejection fraction <45%), arrhythmias, left bundle branch block, comor-bidities (cancer treated with chemotherapy, connective tissue disease) and poor acoustic window. There were 15 patients eligible for the study. GLS was measured in all patients. “SPSS 17” was used for statistics. Continu-ous variables were expressed as mean ± standard devia-tion, categorical variables as percentages and Pearson’s correlation coefficients for the relationship between continuous variables. A p value of <0.05 was conside-red significant.

Results: The mean age was 61.73 ± 9.19 years. Clinical parameters at inclusion were: SBP=137 ± 21,69mmHg, DBP=80.66 ± 10.99 mmHg and HR=73.26 ± 23.77 bpm. According to the results of coronary angiogra-phy the 15 patients were divided into 4 groups: group 1 (n=2) 13.33% – no significant stenosis, group 2 (n=4) 26.66% – 1 vessel CAD, group 3 (n=5) 33.33% – 2 vessels CAD and group 4 (n=4) 26.66% – multivessel CAD. The mean left ventricular ejection fraction was 51.6 ± 6.05%. The mean GLS=-14.66 ± 3.21. There was a statistically significant difference between mean GLS in normal coronaries compared to different degrees of CAD (−18.55 ± 2.33 in gr.1, compared to−17.35 ± 1.55 in gr.2, -17.04 ± 3.72 in gr.3 and −14.1 ± 8.06 in gr.4 re-spectively, p=0.03). There was a weak positive correlati-on between the number of coronary vessels affected by stenosis and the value of GLS (r=0.33, p=0.27). There was a weak positive correlation between GLS and LVEF (r=0.079; p=0.79).

Conclusions: Although small, our study demonstrated a significant correlation between the severity of coro-nary artery disease and the GLS value. We emphasize that larger studies are needed to investigate further the usefulness and accuracy of GLS in predicting the pre-sence, extent and severity of coronary artery disease.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)