Dogdus Mustafa, Kucukosmanoglu Mehmet, Kilic Salih
Department of Cardiology, Usak University, Training and Research Hospital, Usak, Turkey.
Department of Cardiology, University of Health Sciences, Adana Training and Research Hospital, Adana, Turkey.
Echocardiography. 2019 Dec;36(12):2209-2215. doi: 10.1111/echo.14533. Epub 2019 Nov 19.
Coronary artery ectasia (CAE) is an angiographic definition of coronary artery pathology in which the diameter of the ectatic segment measures more than 1.5 times the diameter of an adjacent healthy reference segment. No previous study has reported on the use of 3D-STE for assessing the left ventricular (LV) functions in patients with isolated CAE. As a result of this, we aimed to evaluate the effects of isolated CAE on LV functions using 3D-STE in the present study.
Ninety-one patients with isolated CAE and 90 controls who proved to have normal coronary angiograms were enrolled to the study. 3D-STE was performed and GLS, GCS, GAS, and GRS were obtained for every subject after coronary angiography.
The mean age of the patients was 61.75 ± 10.02 years, and 71.8% were male. GLS, GCS, GAS, and GRS were significantly depressed in the isolated CAE group than in the control group (P < .001; P < .001; P = .001; and P = .001, respectively). ROC analyses were performed to find out the ideal strain cut off values to predict the presence of isolated CAE. A GLS value of >-16 has 92.1 % sensitivity, 88.5 % specificity; and a GCS value of >-20 has 86.7 % sensitivity, 89.2 % specificity to detect the presence of isolated CAE.
Isolated CAE has a considerable negative effect on LV functions as evaluated by 3D-strain parameters, and 3D-STE could be an effective method to detect early stage myocardial impairment in patients with isolated CAE.
冠状动脉扩张（CAE）是冠状动脉病变的一种血管造影定义，其中扩张段的直径测量值超过相邻健康参考段直径的1.5倍。此前尚无研究报道使用三维斑点追踪超声心动图（3D-STE）评估孤立性CAE患者的左心室（LV）功能。因此，在本研究中，我们旨在使用3D-STE评估孤立性CAE对LV功能的影响。
本研究纳入了91例孤立性CAE患者和90例冠状动脉造影显示正常的对照者。在冠状动脉造影后，对每个受试者进行3D-STE检查，并获得整体纵向应变（GLS）、整体圆周应变（GCS）、整体面积应变（GAS）和整体径向应变（GRS）。
患者的平均年龄为61.75±10.02岁，71.8%为男性。孤立性CAE组的GLS、GCS、GAS和GRS均显著低于对照组（分别为P<.001；P<.001；P=.001；P=.001）。进行ROC分析以找出预测孤立性CAE存在的理想应变截断值。GLS值>-16时，检测孤立性CAE存在的敏感性为92.1%，特异性为88.5%；GCS值>-20时，检测孤立性CAE存在的敏感性为86.7%，特异性为89.2%。
通过3D应变参数评估，孤立性CAE对LV功能有相当大的负面影响，3D-STE可能是检测孤立性CAE患者早期心肌损伤的有效方法。
