Summary
During the past several years, 2D STE imaging had been emerged as a quantitative technique to accurately estimate myocardial function and contractility. 2D STE analyzes motion by tracking speckles in the ultrasonic image is simple to perform, and further processing and interpretation can be done offline after image data acquisition.
The aim of this study was to evaluate the diagnostic value of speckle-tracking echocardiography derived myocardial deformation parameters at rest and during dobutamine stress in predicting the presence or absence of significant CAD and determining the hemodynamic significance of the coronary artery stenosis in patients with chronic stable angina. This study included 100 patients with chronic stable angina scheduled for elective DSE.
They were subjected to: full history taking, full clinical examination, 12 leads surface ECG, full echocardiographic study, high dose DSE, 2D STE to detect GLPSS at rest and stress and then they underwent CA with calculation of Syntax score.
STE at stress showed better agreement with CA than DSE in detecting coronary artery affection, so adding STE results to DSE provided more additional data. This revealed that STE at stress was an excellent predictor for coronary artery stenosis with a sensitivity of (95%), specificity of (90%), PPV of (97.4%) and NPV of (81.8%).
STE at stress was an excellent predictor for coronary artery stenosis and assessment of GLPSS at peak DSE offered enhanced sensitivity than DSE only. The enhanced sensitivity could prove valuable in clinical practice when assessing intermediate to high risk patients, in order to minimize false negative rates, which could have a negative impact on their outcomes.
Also, Bull’s eye mapping was analyzed territorial-wise; STE showed superior results over DSE in detecting LAD, RCA lesion and multi vessel disease.
There was highly significant inverse correlation between SYNTAX score and GLPSS at rest and stress (r= - 0.555 and -0.532 respectively, P value |
