TY - JOUR
T1 - Layer-specific global longitudinal strain reveals impaired cardiac function in patients with reversible ischemia
AU - Hagemann, Christoffer E.
AU - Hoffmann, Søren
AU - Olsen, Flemming J.
AU - Jørgensen, Peter G.
AU - Fritz-Hansen, Thomas
AU - Jensen, Jan S.
AU - Biering-Sørensen, Tor
PY - 2018
Y1 - 2018
N2 - Aims: Two-dimensional speckle tracking echocardiography (2DSTE) detects early signs of left ventricular dysfunction; however, it is unknown whether layer-specific global longitudinal strain (GLS) has incremental value in diagnosis of patients with reversible ischemia assessed by single photon emission computed tomography (SPECT). Methods and Results: Eighty patients with stable angina pectoris (SAP), normal left ventricular ejection fraction (LVEF), and no history of ischemic heart disease were retrospectively identified to have been examined by 2DSTE, SPECT, and coronary angiography (CAG). Patients with a normal SPECT constituted the control group, and patients with a positive SPECT were divided into patients with or without (true- or false- positive SPECT) significant stenosis assessed by CAG. GLS was measured for two myocardial layers (endocardial and epicardial) and as well as mid-myocardial GLS. Patients with reversible ischemia had significantly lower GLS compared to the control group (GLSE
ndocardial: −19.0 ± 4.4% vs −21.4 ± 3.7%, P =.011; GLSE
picardial: −14.3 ± 2.9% vs −16.3 ± 2.9%, P =.004); GLSM
id-myocardial: −16.5 ± 3.6% vs −18.6 ± 3.2%, P =.006. This difference was even more evident in patients with a true-positive SPECT (GLSE
ndocardial: −18.0 ± 4.4% vs −21.4 ± 3.7%, P <.001; GLSE
picardial: −13.6 ± 3.0% vs −16.3 ± 2.9%, P <.001); GLSM
id-myocardial: −15.6 ± 3.6% vs −18.6 ± 3.2%, P <.001. Notably, no significant differences existed in patients with a false-positive SPECT. GLSE
picardial was the only independent predictor of coronary artery disease. In conclusion: In patients with SAP and preserved LVEF, layer-specific GLS at rest identifies patients with reversible ischemia. This seems to be evident only in patients with a true-positive SPECT, thus, 2DSTE at rest might improve the diagnostic accuracy of a positive SPECT.
AB - Aims: Two-dimensional speckle tracking echocardiography (2DSTE) detects early signs of left ventricular dysfunction; however, it is unknown whether layer-specific global longitudinal strain (GLS) has incremental value in diagnosis of patients with reversible ischemia assessed by single photon emission computed tomography (SPECT). Methods and Results: Eighty patients with stable angina pectoris (SAP), normal left ventricular ejection fraction (LVEF), and no history of ischemic heart disease were retrospectively identified to have been examined by 2DSTE, SPECT, and coronary angiography (CAG). Patients with a normal SPECT constituted the control group, and patients with a positive SPECT were divided into patients with or without (true- or false- positive SPECT) significant stenosis assessed by CAG. GLS was measured for two myocardial layers (endocardial and epicardial) and as well as mid-myocardial GLS. Patients with reversible ischemia had significantly lower GLS compared to the control group (GLSE
ndocardial: −19.0 ± 4.4% vs −21.4 ± 3.7%, P =.011; GLSE
picardial: −14.3 ± 2.9% vs −16.3 ± 2.9%, P =.004); GLSM
id-myocardial: −16.5 ± 3.6% vs −18.6 ± 3.2%, P =.006. This difference was even more evident in patients with a true-positive SPECT (GLSE
ndocardial: −18.0 ± 4.4% vs −21.4 ± 3.7%, P <.001; GLSE
picardial: −13.6 ± 3.0% vs −16.3 ± 2.9%, P <.001); GLSM
id-myocardial: −15.6 ± 3.6% vs −18.6 ± 3.2%, P <.001. Notably, no significant differences existed in patients with a false-positive SPECT. GLSE
picardial was the only independent predictor of coronary artery disease. In conclusion: In patients with SAP and preserved LVEF, layer-specific GLS at rest identifies patients with reversible ischemia. This seems to be evident only in patients with a true-positive SPECT, thus, 2DSTE at rest might improve the diagnostic accuracy of a positive SPECT.
KW - coronary artery disease
KW - echocardiography
KW - myocardial strain
U2 - 10.1111/echo.13830
DO - 10.1111/echo.13830
M3 - Journal article
C2 - 29446126
AN - SCOPUS:85042052660
SN - 0742-2822
VL - 35
SP - 632
EP - 642
JO - Echocardiography
JF - Echocardiography
IS - 5
ER -