Role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast-enhanced stress echocardiography

Abstract Introduction The aim of this study is to analyze the diagnostic value of global longitudinal strain (GLS) in detecting inducible myocardial ischemia in patients with chest pain undergoing treadmill contrast-enhanced stress echocardiography (SE). Methods We retrospectively enrolled all patie...

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Main Authors: Rami M. Abazid, Nilkanth Patil, Maged Elrayes, Mark Chandy, Magdi Hassanin, Andrew Mathew, Sabe De, Rodrigo Bagur, Nikolaos Tzemos
Format: Article
Language:English
Published: BMC 2024-05-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-024-03926-8
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author Rami M. Abazid
Nilkanth Patil
Maged Elrayes
Mark Chandy
Magdi Hassanin
Andrew Mathew
Sabe De
Rodrigo Bagur
Nikolaos Tzemos
author_facet Rami M. Abazid
Nilkanth Patil
Maged Elrayes
Mark Chandy
Magdi Hassanin
Andrew Mathew
Sabe De
Rodrigo Bagur
Nikolaos Tzemos
author_sort Rami M. Abazid
collection DOAJ
description Abstract Introduction The aim of this study is to analyze the diagnostic value of global longitudinal strain (GLS) in detecting inducible myocardial ischemia in patients with chest pain undergoing treadmill contrast-enhanced stress echocardiography (SE). Methods We retrospectively enrolled all patients who underwent invasive coronary angiography after treadmill contrast-enhanced SE. Rest and peak-stress myocardial GLS, segmental LS, and LS of 4-chamber (CH), 2-CH, and 3-CH views were reported. Luminal stenosis of more than 70% or fractional flow reserve (FFR) of < 0.8 was considered significant. Results In total 33 patients were included in the final analysis, among whom sixteen patients (48.4%) had significant coronary artery stenosis. Averaged GLS, 3-CH, and 4-CH LS were significantly lower in patients with critical coronary artery stenosis compared to those without significant stenosis (-17.1 ± 7.1 vs. -24.2 ± 7.2, p = 0.041), (-18.2 ± 8.9 vs. -24.6 ± 8.2, p = 0.045) and (-14.8 ± 6.2 vs. -22.8 ± 7.8, p = 0.009), respectively. Receiver operating characteristic (ROC) analysis of ischemic and non-ischemic segments demonstrated that a cut-off value of -20% of stress LS had 71% sensitivity and 60% specificity for ruling out inducible myocardial ischemia (Area under the curve was AUC = 0.72, P < 0.0001). Conclusion Myocardial LS measured with treadmill contrast-enhanced stress echocardiography demonstrates potential value in identifying patients with inducible myocardial ischemia.
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spelling doaj-art-540bc2a9f30a4fd6b85327df44e59b772025-08-20T02:56:11ZengBMCBMC Cardiovascular Disorders1471-22612024-05-012411810.1186/s12872-024-03926-8Role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast-enhanced stress echocardiographyRami M. Abazid0Nilkanth Patil1Maged Elrayes2Mark Chandy3Magdi Hassanin4Andrew Mathew5Sabe De6Rodrigo Bagur7Nikolaos Tzemos8Northern Ontario Medical School (NOSM) University, Department of Medicine, Sault Area HospitalDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University HospitalDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University HospitalDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University HospitalNorthern Ontario Medical School (NOSM) University, Department of Medicine, Sault Area HospitalDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University HospitalDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University HospitalDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University HospitalDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University HospitalAbstract Introduction The aim of this study is to analyze the diagnostic value of global longitudinal strain (GLS) in detecting inducible myocardial ischemia in patients with chest pain undergoing treadmill contrast-enhanced stress echocardiography (SE). Methods We retrospectively enrolled all patients who underwent invasive coronary angiography after treadmill contrast-enhanced SE. Rest and peak-stress myocardial GLS, segmental LS, and LS of 4-chamber (CH), 2-CH, and 3-CH views were reported. Luminal stenosis of more than 70% or fractional flow reserve (FFR) of < 0.8 was considered significant. Results In total 33 patients were included in the final analysis, among whom sixteen patients (48.4%) had significant coronary artery stenosis. Averaged GLS, 3-CH, and 4-CH LS were significantly lower in patients with critical coronary artery stenosis compared to those without significant stenosis (-17.1 ± 7.1 vs. -24.2 ± 7.2, p = 0.041), (-18.2 ± 8.9 vs. -24.6 ± 8.2, p = 0.045) and (-14.8 ± 6.2 vs. -22.8 ± 7.8, p = 0.009), respectively. Receiver operating characteristic (ROC) analysis of ischemic and non-ischemic segments demonstrated that a cut-off value of -20% of stress LS had 71% sensitivity and 60% specificity for ruling out inducible myocardial ischemia (Area under the curve was AUC = 0.72, P < 0.0001). Conclusion Myocardial LS measured with treadmill contrast-enhanced stress echocardiography demonstrates potential value in identifying patients with inducible myocardial ischemia.https://doi.org/10.1186/s12872-024-03926-8Myocardial strainTreadmillStress EchocardiographyContrast
spellingShingle Rami M. Abazid
Nilkanth Patil
Maged Elrayes
Mark Chandy
Magdi Hassanin
Andrew Mathew
Sabe De
Rodrigo Bagur
Nikolaos Tzemos
Role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast-enhanced stress echocardiography
BMC Cardiovascular Disorders
Myocardial strain
Treadmill
Stress Echocardiography
Contrast
title Role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast-enhanced stress echocardiography
title_full Role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast-enhanced stress echocardiography
title_fullStr Role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast-enhanced stress echocardiography
title_full_unstemmed Role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast-enhanced stress echocardiography
title_short Role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast-enhanced stress echocardiography
title_sort role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast enhanced stress echocardiography
topic Myocardial strain
Treadmill
Stress Echocardiography
Contrast
url https://doi.org/10.1186/s12872-024-03926-8
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