Cardiology Department, Allama Iqbal Medical College/ Jinnah Hospital, Lahore, Pakistan.
2Cardiology Department, Ayub Medical College/ Teaching Hospital, Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2021 Jul-Sep;33(3):393-398.
In patients of non-ST-elevation acute coronary syndrome (NSTEACS), the global longitudinal peak systolic strain (GLPS) has been used to detect the presence of coronary artery disease (CAD) before left ventricular ejection fraction (LVEF) is affected. We tried to find out the correlation between the GLPS and severity of CAD in such patients.
A descriptive correlational study was conducted from March 2018 to January 2020 at Jinnah Hospital Lahore. Two hundred and sixteen patients of NSTEACS with EF of ≥60% were included. Patients were divided according to angiographic results into those having non-significant, one-vessel, two-vessel or three-vessel disease. These four groups were compared regarding left ventricular end-systolic dimension (LVESD), left ventricular end-diastolic dimension (LVEDD), LVEF, global longitudinal peak systolic strains in apical long axis view (GLPS-APLEX), in apical 4-chamber view (GLPS-A4C), in apical 2-chamber view (GLPS-A2C) and average of these (GLPS-AVG). All these parameters were also compared between patients having and those not having left main coronary artery (LMCA) disease.
Out of 216 patients, males and females were 124(57.4%) and 92 (42.6%) respectively. There were 28 (13.0%), 83 (38.4%), 62 (28.7%) and 43 (19.9%) patients who had non-significant, one-vessel, two-vessel and three-vessel CAD respectively. With increase in severity of CAD, GLPS-AVG progressively decreased from nonsignificant CAD being 20.6±0.7 to three-vessel CAD being 16.1±0.7. There was a significant negative correlation between severity of CAD and all of the GLPS-APLEX, GLPS-A4C, GLPSA2C and GLPS-AVG (p<0.001 in all). GLPS-AVG was significantly low in patients having LMCA disease (16.5±0.7) than those not having LMCA disease (18.2±1.5) with p-value of <0.001. All other types of GLPSs showed the similar trend.
Global longitudinal peak systolic strain has a significant negative correlation with severity of coronary artery disease in non-ST-elevation acute coronary syndrome having normal ejection fraction.
在非 ST 段抬高型急性冠状动脉综合征（NSTEACS）患者中，全球纵向峰值收缩期应变（GLPS）已被用于在左心室射血分数（LVEF）受到影响之前检测冠状动脉疾病（CAD）的存在。我们试图找出这种患者的 GLPS 与 CAD 严重程度之间的相关性。
这是一项描述性相关性研究，于 2018 年 3 月至 2020 年 1 月在拉合尔的真纳医院进行。共纳入 216 例 EF≥60%的 NSTEACS 患者。根据血管造影结果将患者分为非显著性、单支血管、双支血管或三支血管病变组。比较这四组患者的左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）、LVEF、心尖长轴观的整体纵向峰值收缩期应变（GLPS-APLEX）、心尖 4 腔观的整体纵向峰值收缩期应变（GLPS-A4C）、心尖 2 腔观的整体纵向峰值收缩期应变（GLPS-A2C）和平均（GLPS-AVG）。还比较了有和无左主干冠状动脉（LMCA）疾病的患者之间的所有这些参数。
216 例患者中，男性和女性分别为 124 例（57.4%）和 92 例（42.6%）。非显著性、单支血管、双支血管和三支血管 CAD 患者分别为 28 例（13.0%）、83 例（38.4%）、62 例（28.7%）和 43 例（19.9%）。随着 CAD 严重程度的增加，GLPS-AVG 逐渐从非显著性 CAD（20.6±0.7）下降至三支血管 CAD（16.1±0.7）。CAD 的严重程度与所有 GLPS-APLEX、GLPS-A4C、GLPSA2C 和 GLPS-AVG 均呈显著负相关（p<0.001）。LMCA 疾病患者的 GLPS-AVG（16.5±0.7）明显低于无 LMCA 疾病患者（18.2±1.5），p 值<0.001。所有其他类型的 GLPS 也呈现出类似的趋势。
在 EF 正常的非 ST 段抬高型急性冠状动脉综合征患者中，GLPS 与冠状动脉疾病的严重程度呈显著负相关。
