Background: Left bundle branch block (LBBB) poses some restriction on coronary artery disease (CAD) diagnosis with
noninvasive diagnostic modalities. Objectives: Evaluating the role of 2-D speckle tracking echocardiography (STE) in the
diagnosis of CAD in patients with LBBB.
Patients and Methods: This was a single-center observational prospective study that lasted for 3 years. 80 patients with
LBBB complaining of exertional chest pain underwent STE and coronary angiography (CA).
Results: 50 patients were put in group I, on exclusion of significant CAD. Group II had 30 patients having significant CAD
on CA. Global longitudinal strain (GLS) of the left ventricle was higher in group II patients (p value of 0.0001). Also, time
to peak strain in apical 2 chamber view (TTPS AP2), apical 3 chamber view (TTPS AP3) and apical 4 chamber view (TTPS
AP4) were significantly higher among group II patients (p-value of 0.0001, 0.0001 and 0.0001 respectively). GLS can
predict significant CAD using cutoff point of 11.4%, with sensitivity of 66% and specificity of 90% (p-value 0.0001). TTPS
AP2 can predict significant CAD using cutoff point of 399.5 milliseconds (ms), with a sensitivity of 90% and specificity of
58% (p value 0.0001). TTPS AP3 can predict significant CAD using cutoff point of 385.5 ms, with a sensitivity of 73.3%
and specificity of 72% (p-value of 0.0001). TTPS AP4 can predict significant CAD using cutoff point of 377.5 ms, with
sensitivity of 90% and specificity of 52% (p-value of 0.0001).
Conclusion: STE could be valuable in the assessment of LBBB patient with suspected CAD.
|
