[en] Dobutamine stress echocardiography (DSE) is sensitive but subjective diagnostic tool to detect inducible ischemia. Nowadays, speckle tracking allows an objective quantification of regional wall function. We aimed to investigate the feasibility and accuracy of global (GLS) and regional longitudinal strain (RLS) during DSE to detect significant coronary stenosis (SCS). We conducted a prospective observational multicenter study including patients undergoing DSE for suspected SCS. 50 patients with positive DSE underwent coronary angiography. Besides visual regional wall motion score index (WMSI), GLS and RLS were determined at rest and at peak stress by Automated Function Imaging. DSE GLS feasibility was 96%. Among 35 patients with SCS, 12 patients were affected by multivessel disease, 18 had stenosis of left anterior descending artery (LAD), 18 of left circumflex (LCX) and 15 of right coronary artery (RCA). At peak stress, both GLS reduction (p = 0.037) and WMSI worsening (p = 0.04) showed significant agreement with coronary angiography for detecting SCS. When single lesion was considered, peak stress GLS and LAD RLS were lower in the obstructed LAD regions than in normo-perfused territories (17.4 ± 5.5 vs. 20.5 ± 4.4%, p = 0.03; 17.1 ± 7.6 vs. 21.6 ± 5.5%, p < 0.02, respectively). Furthermore, the addition of RLS to regional WMSI was able to improve accuracy in LAD SCS prediction (AUC 0.68, p = 0.037). Conversely, in presence of LCX or RCA SCS, LS was less accurate than WMSI at peak stress. In conclusion, DSE strain analysis is feasible and may improve prediction of LAD SCS, whereas regional WMSI assessment performs better in presence of SCS of LCX and RCA.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Ilardi, Federica ; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II ; Mediterranea Cardiocentro, 80122, Napoli, Italy.
Santoro, Ciro; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II
MARECHAL, Patrick ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Dulgheru, Raluca; GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège
Postolache, Adriana ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Esposito, Roberta; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II ; Mediterranea Cardiocentro, 80122, Napoli, Italy.
Giugliano, Giuseppe; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II
Sannino, Anna; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II ; The Heart Hospital Baylor Plano, Plano, TX, USA.
Avvedimento, Marisa; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II
Leone, Attilio; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II
Cirillo, Plinio; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II
Stabile, Eugenio; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II
LANCELLOTTI, Patrizio ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie ; Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and
Esposito, Giovanni; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II
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