Kaya Çağlar, Gürdoğan Muhammet
Trakya University, Department of Cardiology - Edirne, Turkey.
Rev Assoc Med Bras (1992). 2025 May 2;71(3):e20241806. doi: 10.1590/1806-9282.20241806. eCollection 2025.
Myocardial perfusion scintigraphy is a common non-invasive method for assessing ischemic burden, though artifacts can affect accuracy. Speckle-tracking strain echocardiography improves left ventricular function assessment, and global longitudinal strain correlates well with coronary artery disease. The aim of this study was to compare myocardial perfusion scintigraphy with global longitudinal strain in stable angina pectoris patients.
A total of 133 suspected coronary artery disease patients who underwent myocardial perfusion scintigraphy and coronary angiography were prospectively enrolled and classified as myocardial perfusion scintigraphy true positives or false positives based on coronary angiography results. Global longitudinal strain values for the epicardium, endocardium, and myocardium (avg) were calculated.
Ischemic percentages of myocardial perfusion scintigraphy>12% and mid-wall global longitudinal strain<-18.4% correlated with true positive coronary angiography results. Left ventricular ejection fraction/global longitudinal strain mid ratio positively correlated with coronary artery disease presence and severity. Higher ischemic percentages of myocardial perfusion scintigraphy showed a negative correlation (r: -0.2606, p: 0.002) with global longitudinal strain, indicating a greater likelihood of coronary artery disease (OR 0.25, 95%CI 0.08-0.73, p: 0.012). Female sex was linked to fewer true positive myocardial perfusion scintigraphy results.
The GLS value of the Left Ventricle obtained by two-dimentional strain echocardiography offers sensitivity and specificity similar to myocardial perfusion scintigraphy in the detection of coronary artery disease.. An elevated left ventricular ejection fraction/global longitudinal strain ratio is a significant predictor of the presence and severity of coronary artery disease.
心肌灌注闪烁扫描术是评估缺血负荷的常用非侵入性方法，不过伪影会影响准确性。斑点追踪应变超声心动图可改善左心室功能评估，整体纵向应变与冠状动脉疾病密切相关。本研究旨在比较稳定型心绞痛患者的心肌灌注闪烁扫描术与整体纵向应变。
前瞻性纳入133例疑似冠状动脉疾病且接受了心肌灌注闪烁扫描术和冠状动脉造影的患者，并根据冠状动脉造影结果将其分类为心肌灌注闪烁扫描术真阳性或假阳性。计算心外膜、心内膜和心肌（平均值）的整体纵向应变值。
心肌灌注闪烁扫描术缺血百分比>12%且中层心肌整体纵向应变<-18.4%与冠状动脉造影真阳性结果相关。左心室射血分数/整体纵向应变中层比值与冠状动脉疾病的存在和严重程度呈正相关。心肌灌注闪烁扫描术较高的缺血百分比与整体纵向应变呈负相关（r：-0.2606，p：0.002），表明冠状动脉疾病的可能性更大（OR 0.25，95%CI 0.08 - 0.73，p：0.012）。女性与心肌灌注闪烁扫描术较少的真阳性结果相关。
二维应变超声心动图获得的左心室GLS值在检测冠状动脉疾病方面提供了与心肌灌注闪烁扫描术相似的敏感性和特异性。左心室射血分数/整体纵向应变比值升高是冠状动脉疾病存在和严重程度的重要预测指标。
