Determining the Changes in Value of Segmental Longitudinal Strain and Global Longitudinal Strain in Discriminating Left Anterior Descending Artery Involvement: SLS and GLS Changes in Discriminating LADA Involvement
Introduction: The present study was conducted to determine the predictive role of the segmental longitudinal strain in predicting significant proximal left anterior descending stenosis in patients with coronary heart disease regarding specific cardiac segments.
Materials and Methods: This cross-sectional study was conducted on 90 consecutive patients who were candidates for coronary angiography and assessed using speckle-tracking echocardiography. All patients underwent echocardiography prior to coronary angiography and only patients with normal left ventricular ejection fraction were finally included. Besides, conventional echocardiography, all patients were subjected to speckle-tracking echocardiography determination, and the images were assessed in standard 3C, 2C, 4C views.
Results: 45 patients with significant proximal left anterior descending stenosis found from the coronary angiography report and 45 patients with had normal coronary arteries. Based on the surface area under the receiver operating characteristic curve analysis, the highest diagnostic ability to distinguish between left anterior descending involvement from normal coronary state was related to the segmental longitudinal strain of the septal basal segments (AUC = 0.962), anteroseptal apical (AUC = 0.942) and septal mid portion (AUC = 0.941) . For global longitudinal strain it was -20.45 (100% sensitivity, 95.5% specificity) regarding the global longitudinal strain diagnostic value in the prediction of proximal significant left anterior descending stenosis.
Conclusion: The measurement of segmental longitudinal strain in LAD segments and global longitudinal strain can predict proximal left anterior descending stenosis with high sensitivity and specificity.
Aune E, Hjelmesaeth J, Fox KA, Endresen K, Otterstad JE. High mortality rate in conservatively managed patients with acute coronary syndrome. Scand Cardiovasc J. 2006;40:137–44.
Narallah N, Steiner H, Hasin Y. The challenge of chest pain in the emergency room: now and in the future. Eur Heart J. 2011;32:656.
Ruddox V, Mathisen M, Otterstad JE. Prevalence and prognosis of non-specific chest pain among patients hospitalized for suspected acute coronary syndrome—a systematic literature search. BMC Medicine. 2012;10:58.
Damman P, van Geloven N, Walentin L, Lagerqvist B, Fox CA, Clayton T, et al. Timing of angiography with a routine invasive strategy and long-term outcomes in non-ST segment evaluation acute coronary syndrome: a collaborative analysis of individual patient data from the FRISC II (Fragmin an Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive versus conservative Treatment in Unstable Coronary Syndormes), and RITA-3 (Intervention vs Conservative treatment Strategy in Patients With Unstable Angina or Non-ST elevation Myocardial Infarction) Trial. J Am Coll Cardiol Intv. 2012;5:191–9.
Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. ESC guidelines on the management of stable coronary artery disease. European Heart Journal. 2013;2013(34):2949–3003.
Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromen (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology. European Heart Journal. 2011;32:2999–3054.
Feigenbaum H, Mastouri R, Sawada S. A practical approach to using strain echocardiography to evaluate the left ventricle. Circ J. 2012;76:1550–5.
Jamal F, Sutherland GR, Weidemann F, D’hooge J, Bijnens B, Derumeaux G. Can changes in systolic longitudinal deformation quantify regional myocardial function after an acute infarction? An ultrasonic strain rate and strain study. J Am Soc Echocardiogr. 2002;15:723–730.
Liang HY1, Cauduro S, Pellikka P, Wang J, Urheim S, Yang EH, Rihal C, Belohlavek M, Khandheria B, Miller FA, Abraham TP. Usefulness of two-dimensional speckle strain for evaluation of leftventricular diastolic deformation in patients with coronary artery disease. Am J Cardiol. 2006 Dec 15;98(12):1581-6. Epub 2006 Oct 25.
Tsai WC1, Liu YW, Huang YY, Lin CC, Lee CH, Tsai LM. Diagnostic value of segmental longitudinal strain by automatedfunction imaging in coronary artery disease without left ventriculardysfunction. J Am Soc Echocardiogr. 2010 Nov;23(11):1183-9. doi: 10.1016/j.echo.2010.08.011. Epub 2010 Sep 15.
Choi JO1, Cho SW, Song YB, Cho SJ, Song BG, Lee SC, Park SW. Longitudinal 2D strain at rest predicts the presence of left main and three vessel coronary artery disease in patients without regional wallmotion abnormality. Eur J Echocardiogr. 2009 Jul;10(5):695-701. doi: 10.1093/ejechocard/jep041. Epub 2009 Apr 28.
Nucifora G1, Schuijf JD, Delgado V, Bertini M, Scholte AJ, Ng AC, van Werkhoven JM, Jukema JW, Holman ER, van der Wall EE, Bax JJ. Incremental value of subclinical left ventricular systolic dysfunctionfor the identification of patients with obstructive coronary arterydisease. Am Heart J. 2010 Jan;159(1):148-57. doi: 10.1016/j.ahj.2009.10.030.
Zavar R, Sadeghian H, Lotfi-Tokaldany M, Ashrafi MM, Fathollahi MS, Sadeghian A. Longitudinal Tissue Velocity and Deformation Imaging in Patients with Significant Stenosis of Left Anterior Descending Artery. IMMINV. 2019 Feb 19;4(1). doi:10.24200/imminv.v2i4.197.
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