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左心室功能正常的疑似冠心病患者中斑点追踪超声心动图与冠状动脉造影的相关性

The correlation between speckle-tracking echocardiography and coronary angiography in suspected coronary artery disease with normal left ventricular function.

作者信息

Yadav Krishan, Prajapati Jayesh, Singh Gaurav, Patel Iva, Karre Ajay, Bansal Pradeep Kumar, Garhwal Vicky

机构信息

Yatharth Super Speciality Hospital, Noida, UP, India.

Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India.

出版信息

J Cardiovasc Thorac Res. 2022;14(4):234-239. doi: 10.34172/jcvtr.2022.30520. Epub 2022 Dec 17.

Abstract

Our study objects to determine the diagnostic accuracy of two-dimensional speckle tracking echocardiography (2DSTE) in predicting presence and severity of coronary artery disease (CAD). Patients with stable angina pectoris with normal left ventricular function (>50%) undergoing coronary angiography were enrolled and subjected to speckle tracking echocardiography. Global longitudinal peak systolic strain was measured and correlated to the results of coronary angiography for each patient. Number of male (=0.001), diabetes (=0.01) and smoking (=0.01) patients were significantly higher in the CAD group compared to non-CAD patients. Global longitudinal peak systolic strain (GLPSS) was significantly (=0.0001) lower in CAD patients in comparison to non- CAD patients. GLPSS showed significantly lower in patients with Syntax score (SS)≥22 in comparison to SS<22. Cut-off value -19 for GLPSS could be used to predict the presence of significant CAD with 80.6% sensitivity and 76.5% specificity (area under curve (AUC) -0.83, =0.0001). The mean GLPSS value decreased as the number of diseased coronary vessels increased (=0.0001). The optimal cut-off value of -16 GLPSS with a sensitivity of 76.7% and specificity of 83.3% [AUC 0.84, <0.0001] was found significant to predict CAD severity. Multivariate regression of GLPSS and another risk factor for predicting significant CAD, GLPSS showed OR=1.55 (CI-1.36-1.76) =0.0001 for predicting the presence of CAD. 2DSTE can be used as a non-invasive screening test in predicting presence, extent and severity of significant CAD patients with suspected stable angina pectoris.

摘要

我们的研究旨在确定二维斑点追踪超声心动图(2DSTE)在预测冠状动脉疾病(CAD)的存在及严重程度方面的诊断准确性。纳入接受冠状动脉造影且左心室功能正常(>50%)的稳定型心绞痛患者,并对其进行斑点追踪超声心动图检查。测量每位患者的整体纵向收缩期峰值应变,并将其与冠状动脉造影结果进行关联。与非CAD患者相比,CAD组男性(=0.001)、糖尿病患者(=0.01)和吸烟患者(=0.01)的数量显著更高。与非CAD患者相比,CAD患者的整体纵向收缩期峰值应变(GLPSS)显著更低(=0.0001)。与Syntax评分(SS)<22的患者相比,SS≥22的患者GLPSS显著更低。GLPSS的截断值-19可用于预测显著CAD的存在,敏感性为80.6%,特异性为76.5%(曲线下面积(AUC)-0.83,=0.0001)。随着病变冠状动脉血管数量的增加,平均GLPSS值降低(=0.0001)。发现GLPSS的最佳截断值为-16,敏感性为76.7%,特异性为83.3%[AUC 0.84,<0.0001],对预测CAD严重程度具有显著意义。GLPSS与预测显著CAD的另一个危险因素的多变量回归分析显示,GLPSS预测CAD存在的比值比(OR)=1.55(置信区间-1.36 - 1.76)=0.0001。2DSTE可作为一种非侵入性筛查试验,用于预测疑似稳定型心绞痛的显著CAD患者的存在、范围和严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a76/9871166/1bac57b4ba26/jcvtr-14-234-g001.jpg

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