Authors: Abdulaziz aboshahba, Hani Khalaf, Ali Alamin, Sami Nouh, Abdulaziz Rezq, Ahmed H Dawood, Ibrahim Altaj, Gamal Abdelhady, Mohamed Elbordy, Raphael Solomon, Abdelmohsen Mostafa.
Background: The assessment of left ventricular (LV) longitudinal strain and strain rate using two-dimensional speckletracking echocardiography increases the sensitivity for detecting myocardial ischemia compared to the visual assessment with RWMA so increase the detection of coronary artery disease.
Aim of the work: The aim of this study was to evaluate the diagnostic value of left ventricular global longitudinal strain and strain rate during the recovery stage after dobutamine stress echocardiography (DSE) for detection of significant coronary artery disease (CAD).
Patients and Methods: The study conducted on 43 patients (27 males and 16 females) with suspected CAD. All patients underwent dobutamine echo. Offline STE and coronary angiography. We excluded all patients with RWMA at rest. The data was analyzed using MedCalc software using ROC curve and Correlations methods.
Results: There was significant reduction in global longitudinal strains at recovery in the patients with significant CAD in comparison to patients with normal coronary angiography (P value <0.0001) with a sensitivity and a specificity of 91.7% and 88.9% respectively. Systolic strain rate (SSR) was increased in CAD (-) group from rest to low dose and at recovery stages, mean were (-1.9, 2.4 and 2.4) respectively while blunted from rest to low dose and during recovery in CAD (+) group, mean were (-2, -2.1 and -1.4) respectively. The optimal cutoff value of SSR at recovery for detection of CAD was -2.05 (sensitivity 96%, specificity 88.6). The territorial longitudinal strains at LAD, LCX and RCA territories did not differ significantly in patients with CAD whatever the coronary lesion.
Conclusion: The measurement longitudinal strain and strain rate using STE at recovery stage after dobutamine echo is sensitive and accurate tool in the identification of CAD and nearly equal to expel1 wall motion analysis. This supports its use as screening test to identify and risk-stratify CAD.
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