Role of global longitudinal strain and left ventricular elastance in assessing myocardial ischemia for patients with moderate probability of CAD

Abstract

INTRODUCTION Dobutamine stress echocardiography (DSE) has potential limitations surrounding image quality, dependence on expert observers and lack of quantitation which decrease it‘s diagnostic value. Global longitudinal strain (GLS) and left ventricular (LV) elastance are new techniques which could be easily done during DSE but their role to detect myocardial ischemia still is not proven. AIM To compare the diagnostic value of GLS and LV elastance at rest and during peak dobutamine doses to predict significant coronary artery stenosis in patients with moderate probability of coronary artery disease (CAD). METHODS DSE and adenosine magnetic resonance imaging (AMRI) were perfomed to 100 patients with moderate probability of. CAD was defined as >70% diameter coronary artery stenosis on invasive angiography or in the presence of intermediate stenosis (50-75%) validated as hemodynamically significant by AMRI. GLS were analysed using 2D speckle tracking echocardiography (STE) at rest and during peak dobutamine doses. LV elastance was calculated at rest and at peak dobutamine doses from end systolic pressure (ESP)(ESP=0.9xSsystolic blood pressure) and end systolic volume (ESV) using formula : LV elastance = ESP/ESV. Patients were divided into two groups: non-obstructive CAD (-) n=40 (40%) vs obstructive CAD (+) n=60 (60%). The p value less than 0.05 was considered as statistically significant. [...].