Moustafa Shaimaa, Elrabat Khalid, Swailem Fathy, Galal Alaa
Department of Cardiology, Benha Faculty of Medicine, Benha University, and National Heart Institute, Egypt.
Department of Cardiology, Benha Faculty of Medicine, Benha University, and National Heart Institute, Egypt.
Indian Heart J. 2018 May-Jun;70(3):379-386. doi: 10.1016/j.ihj.2017.09.220. Epub 2017 Sep 28.
To examine the value of speckle tracking echocardiography to detect the presence, extent and severity of coronary artery affection in patients with suspected stable angina pectoris.
Two hundred candidates with suspected stable angina pectoris and normal resting conventional echocardiography were subjected to speckle tracking echocardiography and coronary angiography. Global and segmental longitudinal peak systolic strain were assessed and were correlated to the results of coronary angiography for each patient.
There was a statistically significant difference in the mean of global longitudinal peak systolic strain between normal coronaries and different degrees of coronary artery disease (CAD) (-20.11±0.8 for normal, -18.34±2.52 for single vessel, -16.14±2.85 for two vessels, -14.81±2.12 for three vessels, -13.01±2.92 for left main disease). GLPSS showed high sensitivity for the diagnosis of single vessel CAD (90%, specificity 95.1%, cutoff value: -18.44, AUC: 0.954); two vessels disease (90%, sensitivity 88.9%, cutoff value -17.35, AUC: 0.906) and for three vessels CAD (cutoff value -15.33, sensitivity 63% and specificity 72.2% AUC 0.681) segmental LPSS also showed statistical significance for localization of the affected vessel for left anterior descending, left circumflex and right coronary artery (ρ=0.001) and inverse correlation with syntax score that was significant with high and intermediate score (ρ=0.001) and insignificant for low syntax score (ρ value 0.05).
Two-dimensional speckle tracking echocardiography has good sensitivity and specificity to predict the presence, extent and severity of CAD.
探讨斑点追踪超声心动图在检测疑似稳定型心绞痛患者冠状动脉病变的存在、范围及严重程度方面的价值。
对200例疑似稳定型心绞痛且静息常规超声心动图正常的患者进行斑点追踪超声心动图检查及冠状动脉造影。评估整体和节段性纵向峰值收缩期应变,并将其与每位患者的冠状动脉造影结果相关联。
正常冠状动脉与不同程度冠状动脉疾病(CAD)患者的整体纵向峰值收缩期应变均值存在统计学显著差异(正常为-20.11±0.8,单支血管病变为-18.34±2.52,两支血管病变为-16.14±2.85,三支血管病变为-14.81±2.12,左主干病变为-13.01±2.92)。整体纵向峰值收缩期应变对单支血管CAD诊断具有高敏感性(90%,特异性95.1%,截断值:-18.44,曲线下面积:0.954);对两支血管病变(敏感性90%,特异性88.9%,截断值-17.35,曲线下面积:0.906)及三支血管CAD(截断值-15.33,敏感性63%,特异性72.2%,曲线下面积0.681)。节段性纵向峰值收缩期应变对左前降支、左旋支及右冠状动脉病变血管的定位也具有统计学意义(ρ=0.001),且与SYNTAX评分呈负相关,在高分和中等评分时具有显著性(ρ=0.001),在低分SYNTAX评分时无显著性(ρ值0.05)。
二维斑点追踪超声心动图在预测CAD的存在、范围及严重程度方面具有良好的敏感性和特异性。