Global longitudinal strain in the prediction of significant coronary artery disease: how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction?
Abstract Background GLS is a non-invasive imaging test that can be useful in the selection of patients highly suspected of CCS for coronary angiogram. Aims This study aimed to evaluate the diagnostic performance of rest 2D speckle tracking echocardiography (2D-STE) for detecting obstructive coronary...
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BMC
2025-07-01
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| Series: | Echo Research and Practice |
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| Online Access: | https://doi.org/10.1186/s44156-025-00084-1 |
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| author | Mame Madjiguene Ka Serigne Cheikh Tidiane Ndao Waly Niang Mboup Mariama Barry Rabab Yassine Pape Momar Guissé Demba Waré Baldé Tacko Niang Djibril Marie Ba Khadidiatou Dia El Hadji Mbacké Sarr Ibrahima Bara Diop Mouhamed Chérif Mboup |
| author_facet | Mame Madjiguene Ka Serigne Cheikh Tidiane Ndao Waly Niang Mboup Mariama Barry Rabab Yassine Pape Momar Guissé Demba Waré Baldé Tacko Niang Djibril Marie Ba Khadidiatou Dia El Hadji Mbacké Sarr Ibrahima Bara Diop Mouhamed Chérif Mboup |
| author_sort | Mame Madjiguene Ka |
| collection | DOAJ |
| description | Abstract Background GLS is a non-invasive imaging test that can be useful in the selection of patients highly suspected of CCS for coronary angiogram. Aims This study aimed to evaluate the diagnostic performance of rest 2D speckle tracking echocardiography (2D-STE) for detecting obstructive coronary artery disease (CAD) in patients with high clinical probability of chronic coronary syndrome (CCS) and preserved left ventricular ejection fraction (LVEF). Methods A prospective study enrolled 52 patients referred for coronary angiography due to highly suspected CCS. Participants were divided into CAD+ (significant stenosis) and CAD- (normal or non-significant stenosis). Transthoracic echocardiography (TTE), exercise EKG, 2D-STE, and coronary angiography were performed. Global longitudinal peak systolic strain (GLS) was calculated using 2D-STE, with a cut-off value of -18% for normal GLS. Reproducibility was assessed with intraclass correlation. Results The mean age of participants was 62.5 ± 11.9 years, and 63.5% were male. The CAD + group (51.9%) had significantly higher rates of hypertension, diabetes, dyslipidemia, and typical angina. GLS was significantly lower in the CAD + group (-15.89 ± 2.07%) compared to the CAD- group (-18.99 ± 2.37%, p = 0.0001). The optimal GLS cut-off for detecting significant coronary lesions was − 16.9%, with 74% sensitivity, 76% specificity, and an area under the curve (AUC) of 0.83 (95% CI 0.73–0.94). GLS correlated with the number of diseased vessels (p = 0.0001) but not with lesion complexity (SYNTAX score, p = 0.18). Regional strain was significantly reduced in patients with obstructive lesions in the left anterior descending (LAD) and circumflex arteries (CX), with optimal cut-offs at -19.2% and − 15.8%, respectively. GLS showed excellent inter-operator reproducibility (ICC = 0.94, p < 0.0001). Conclusion GLS demonstrates good diagnostic performance in detecting obstructive CAD in patients with a high pre-test probability of CCS and preserved LVEF. It serves as a reliable, reproducible indicator of significant coronary lesions, with promising clinical utility for non-invasive CAD assessment, particularly in resource-limited settings. |
| format | Article |
| id | doaj-art-b32e086a4fd74801992e902073d435f0 |
| institution | Kabale University |
| issn | 2055-0464 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | Echo Research and Practice |
| spelling | doaj-art-b32e086a4fd74801992e902073d435f02025-08-20T03:38:14ZengBMCEcho Research and Practice2055-04642025-07-011211910.1186/s44156-025-00084-1Global longitudinal strain in the prediction of significant coronary artery disease: how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction?Mame Madjiguene Ka0Serigne Cheikh Tidiane Ndao1Waly Niang Mboup2Mariama Barry3Rabab Yassine4Pape Momar Guissé5Demba Waré Baldé6Tacko Niang7Djibril Marie Ba8Khadidiatou Dia9El Hadji Mbacké Sarr10Ibrahima Bara Diop11Mouhamed Chérif Mboup12Principal Hospital of DakarPrincipal Hospital of DakarPrincipal Hospital of DakarPrincipal Hospital of DakarPrincipal Hospital of DakarPrincipal Hospital of DakarMilitary Hospital of OuakamMilitary Hospital of OuakamMilitary Hospital of OuakamPrincipal Hospital of DakarNational Hospital Center of FannNational Hospital Center of FannPrincipal Hospital of DakarAbstract Background GLS is a non-invasive imaging test that can be useful in the selection of patients highly suspected of CCS for coronary angiogram. Aims This study aimed to evaluate the diagnostic performance of rest 2D speckle tracking echocardiography (2D-STE) for detecting obstructive coronary artery disease (CAD) in patients with high clinical probability of chronic coronary syndrome (CCS) and preserved left ventricular ejection fraction (LVEF). Methods A prospective study enrolled 52 patients referred for coronary angiography due to highly suspected CCS. Participants were divided into CAD+ (significant stenosis) and CAD- (normal or non-significant stenosis). Transthoracic echocardiography (TTE), exercise EKG, 2D-STE, and coronary angiography were performed. Global longitudinal peak systolic strain (GLS) was calculated using 2D-STE, with a cut-off value of -18% for normal GLS. Reproducibility was assessed with intraclass correlation. Results The mean age of participants was 62.5 ± 11.9 years, and 63.5% were male. The CAD + group (51.9%) had significantly higher rates of hypertension, diabetes, dyslipidemia, and typical angina. GLS was significantly lower in the CAD + group (-15.89 ± 2.07%) compared to the CAD- group (-18.99 ± 2.37%, p = 0.0001). The optimal GLS cut-off for detecting significant coronary lesions was − 16.9%, with 74% sensitivity, 76% specificity, and an area under the curve (AUC) of 0.83 (95% CI 0.73–0.94). GLS correlated with the number of diseased vessels (p = 0.0001) but not with lesion complexity (SYNTAX score, p = 0.18). Regional strain was significantly reduced in patients with obstructive lesions in the left anterior descending (LAD) and circumflex arteries (CX), with optimal cut-offs at -19.2% and − 15.8%, respectively. GLS showed excellent inter-operator reproducibility (ICC = 0.94, p < 0.0001). Conclusion GLS demonstrates good diagnostic performance in detecting obstructive CAD in patients with a high pre-test probability of CCS and preserved LVEF. It serves as a reliable, reproducible indicator of significant coronary lesions, with promising clinical utility for non-invasive CAD assessment, particularly in resource-limited settings.https://doi.org/10.1186/s44156-025-00084-1Global longitudinal strainChronic coronary syndromeDiagnostic performanceSYNTAX scoreRegional longitudinal strainsub-Saharan Africa |
| spellingShingle | Mame Madjiguene Ka Serigne Cheikh Tidiane Ndao Waly Niang Mboup Mariama Barry Rabab Yassine Pape Momar Guissé Demba Waré Baldé Tacko Niang Djibril Marie Ba Khadidiatou Dia El Hadji Mbacké Sarr Ibrahima Bara Diop Mouhamed Chérif Mboup Global longitudinal strain in the prediction of significant coronary artery disease: how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction? Echo Research and Practice Global longitudinal strain Chronic coronary syndrome Diagnostic performance SYNTAX score Regional longitudinal strain sub-Saharan Africa |
| title | Global longitudinal strain in the prediction of significant coronary artery disease: how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction? |
| title_full | Global longitudinal strain in the prediction of significant coronary artery disease: how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction? |
| title_fullStr | Global longitudinal strain in the prediction of significant coronary artery disease: how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction? |
| title_full_unstemmed | Global longitudinal strain in the prediction of significant coronary artery disease: how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction? |
| title_short | Global longitudinal strain in the prediction of significant coronary artery disease: how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction? |
| title_sort | global longitudinal strain in the prediction of significant coronary artery disease how accurate is it for patients with a high clinical probability of chronic coronary syndrome and preserved left ventricular ejection fraction |
| topic | Global longitudinal strain Chronic coronary syndrome Diagnostic performance SYNTAX score Regional longitudinal strain sub-Saharan Africa |
| url | https://doi.org/10.1186/s44156-025-00084-1 |
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