2D - Strain Imaging and Its Diagnostic Value in Patients with Suspected Coronary Artery Disease

Abstract

Strain imaging (SI) has been shown to quantify regional myocardial function in both acute ischemic myocardium and infarcted myocardium. The aim of this study is to determine the diagnostic value of SI for the detection and localization of coronary lesions in pts with chest pain, but without apparent wall motion abnormalities. SI for advanced wall motion analysis was performed in 59 pts with suspicious stable angina (SA) and in 57 pts with suspicious unstable angina (UA), prior to coronary angiography(CAG). Longitudinal strain was measured in 3 apical views, assessments of the strain value for individual segments of the LV were performed to determine the average strain value. For the identification of ischemia a magnitude parameter, being defined as a reduction of the peak systolic strain, was used. A homogenous pattern of strain was defined as relatively uniform distribution of the peak systolic strain. Heterogeneity of strain was considered abnormal; these segments were called strain (+) and the rest were called strain (-). Significant CAD was considered present if stenosis > 70% was noted on the quantitative CAG. Ultrasound-based SI demonstrates a strong correlation with CAG and it has potential as a noninvasive diagnostic tool for detecting CAD in pts with chest pain and without wall motion abnormalities on conventional echocardiography.