Incremental value of 2-dimensional longitudinal radial and circumferential speckle tracking strain imaging to wall motion analysis for detection of coronary artery disease in patients undergoing dobutamine stress echocardiography

Abstract

During the past several years, 2D STE imaging has emerged as a quantitative technique to accurately estimate myocardial function and contractility. 2D STE analyzes motion by tracking speckles in the ultrasonic image. It is simple to perform, and requires only one cardiac cycle to be acquired; further processing and interpretation can be done offline after image data acquisition. The aim of the study was to: determine and compare optimal cutoff values for longitudinal, radial and circumferential strains at peak DSE for detection of significant stenosis as compared to coronary angiography and also to detect any incremental value of combining strain measurements to wall motion analysis for patients with suspected CAD. The study included 80 patients who presented to the Cardiology Department at Ain Shams University Hospitals. They were subjected to: thorough history taking, full clinical examination, 12 leads surface ECG, full echocardiographic study, high dose DSE, 2D STE and CA. This study showed a significant difference between the mean GLS and GCS in diseased patients compared to normal Summary 92 ones. Also, the optimal cutoff values for longitudinal, circumferential, and radial strains during peak DSE by 2D STE were calculated, longitudinal strain analysis had significantly higher accuracy compared to circumferential and radial strains, it showed the highest AUC=0.735 with the highest balanced sensitivity and specificity to predict CAD.