Objective Non-selective coronary angiography (CAG), particularly for atypical chest pain, has increased economic burden of coronary artery disease (CAD) as one third of chest pain were not of coronary origin. Non-invasive diagnosis tools for CAD usually require stress test which is sometime found not appropriate in clinical use. We evaluated a non-invasive and cost benefit method, Speckle Tracking Echocardiography (STE), for detecting CAD and predicting its severity.
Methods Standard echocardiography, two dimensional (2D), and three dimensional (3D) STE were performed in 116 and 62 subjects with and without CAD, respectively based on clinical and angiographic finding. Global peak systolic longitudinal (GLS) and circumferential strains (GCS) were calculated.
Results Value of 2DGLS and 3DGLS decreased in CAD group and declined progressively from normal toward infarction group (–16.92 ± 2.44% vs –13.67 ± 3.02% vs –11.09 ± 2.74%, –17.43 ± 3.41% vs –14.69 ± 2.56% vs –10.80 ± 2.39%, all p < 0.001). Compared to normal group, 2DGLS and 3DGLS decreased in 1-or 2-vessels and 3-vessels disease group (–16.92 ± 2.45% vs –13.66 ± 2.74% vs –11.10 ± 3.14%, –17.43 ± 3.41% vs –14.38 ± 2.85% vs –11.25 ± 2.58%, respectively, all p < 0.001). CAD with stenosis of ≥90% had lower 2DGLS and 3DGLS than stenosis –15.70, > –12.75, > –13.25, and > –14.04 for 3DGLS had sensitivity and specificity of 81.90% and 70.35%, 81.25% and 87.69%, 80.00% and 77.34%, 84.93% and 80.00% in identifying the presence of CAD, myocardial infarction, 3-vessels disease, and stenosis ≥ 90%, respectively.
Conclusions 3DGLS showed similar accuracy with 2DGLS in detecting CAD and predicting its severity. Although comparable, the values obtained from these two methods are not interchangeable. Speckle Tracking Echocardiography could detect altered myocardial function in patient with CAD and is therefore, a valuable non-invasive test before performing CAG.
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