Left ventricular longitudinal strain impairment at rest correlates with reduction of SPECT-derived coronary flow reserve in patients with suspected coronary artery disease. (14th October 2021)

• Record Type: Journal Article
• Authors: Cygulska, K M; Blaszczyk, M; Kasprzak, J D; Wejner-Mik, P; Frynas-Jonczyk, K; Plachcinska, A; Kusmierek, J; Cichocki, P; Lipiec, P
• Is Part Of: European heart journal. Volume 42(2021)Supplement 1
• Publication Date: 2021-10-14
• Subjects: Tissue Doppler, Speckle Tracking and Strain Imaging; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab724.017
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Speckle tracking echocardiography (STE) may be useful for the detection of subclinical systolic function abnormalities. Dynamic acquisition of myocardial blood flow using 99mTc-MIBI SPECT-CZT gamma camera allows the calculation of coronary flow reserve (CFR). Purpose: The aim of our study is to assess the relationship between left ventricular longitudinal strain (LS) and CFR in patients with suspected coronary artery disease (CAD). Methods: 55 patients (pts) (43.6% females, mean age 64.6±8.4 years) with suspected CAD underwent transthoracic echocardiography with assessment global and local LS by STE. We calculated mean global left ventricular LS (GLS), as well as LS of individual coronary artery territories (LAD LS, LCx LS and RCA LS). All pts underwent myocardial perfusion study with novel solid-state CZT nuclear camera (dipyridamole stress protocol). We measured CFR of the left ventricle and individual coronary territories. Results: Mean absolute GLS in pts with total CFR <2 was significantly lower than in pts with CFR >2 (median value −13.9 vs −18.3; p<0.001). Similar differences were observed in all three coronary territories (p≤0.01). Modest but significant correlations were detected between total CFR and GLS values (r=−0.56; p<0.001), LAD CFR and LAD LS (r=−0.54; p<0.001), RCA CFR and RCA LS (r=−0.36; p=0.007), LCx CFR and LCx LS (r=−0.53; p<0.001). GLS at rest had good diagnostic value for detecting total CFR <2 (AUC=0.767; p<0.001). The criterion with the highest diagnostic accuracy was GLS > (−15.8) – its sensitivity was 68%, specificity 77.7%, and overall accuracy 73%. Conclusions: Indices of left ventricular longitudinal function obtained by speckle tracking echocardiography correlate with SPECT-derived CFR in patients with suspected CAD. Funding Acknowledgement: Type of funding sources: None.