Reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndrome
BackgroundIn chronic coronary syndrome (CCS), assessing myocardial ischemia is difficult due to its variable severity. Myocardial mechanical parameters are helpful in ischemia detection. This study investigates the use of non-invasive myocardial work (MW) for ischemia detection and risk assessment i...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1598453/full |
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| author | Ruohan Zhao Ruohan Zhao Ruohan Zhao Jing Zhang Jing Zhang Jing Zhang Yu Xie Yu Xie Yu Xie Yuting Tan Yuting Tan Yuting Tan Benling Qi Lijuan Bai Jingjing Wu Min Cheng Xiang Wang Qing Lv Qing Lv Qing Lv Jing Wang Jing Wang Jing Wang Mingxing Xie Mingxing Xie Mingxing Xie |
| author_facet | Ruohan Zhao Ruohan Zhao Ruohan Zhao Jing Zhang Jing Zhang Jing Zhang Yu Xie Yu Xie Yu Xie Yuting Tan Yuting Tan Yuting Tan Benling Qi Lijuan Bai Jingjing Wu Min Cheng Xiang Wang Qing Lv Qing Lv Qing Lv Jing Wang Jing Wang Jing Wang Mingxing Xie Mingxing Xie Mingxing Xie |
| author_sort | Ruohan Zhao |
| collection | DOAJ |
| description | BackgroundIn chronic coronary syndrome (CCS), assessing myocardial ischemia is difficult due to its variable severity. Myocardial mechanical parameters are helpful in ischemia detection. This study investigates the use of non-invasive myocardial work (MW) for ischemia detection and risk assessment in CCS patients.MethodThe study included 115 patients (70 men, mean age 61 years) with suspected or diagnosed CCS in the derivation cohort and 62 patients in the validation cohort. All patients underwent regadenoson stress echocardiography, with early ischemia indicated by coronary flow velocity reserve (CFVR) <2.5. The patients were categorized based on CFVR, and logistic regression was used to assess the association between myocardial work (MW) and ischemia. Model performance was evaluated for accuracy, prediction, and practicality. The risk stratification thresholds were set by sensitivity and specificity.ResultsOf the 115 patients, 48 (41.74%) had myocardial ischemia. MW was more sensitive in detecting ischemia than global longitudinal strain. Multivariate analysis showed that global constructive work reserve (△GCW) was independently correlated with CFVR, with the highest AUC (0.777). A model including △GCW and hemoglobin identified ischemia with a C-index of 0.844 in the derivation cohort and 0.82 in the validation cohort, allowing calculation of the probability of ischemia in CCS. Risk levels were defined by probabilities of 20% (low) and 70% (high).ConclusionThe incorporation of △GCW and hemoglobin into the prediction model enhances its ability to estimate myocardial ischemia risk. △GCW offered higher sensitivity and incremental diagnostic value in detecting myocardial ischemia in the heterogeneous CCS population. |
| format | Article |
| id | doaj-art-e9ef0db3a06f44698927bcc578fa0159 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-e9ef0db3a06f44698927bcc578fa01592025-08-20T03:34:20ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-08-011210.3389/fcvm.2025.15984531598453Reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndromeRuohan Zhao0Ruohan Zhao1Ruohan Zhao2Jing Zhang3Jing Zhang4Jing Zhang5Yu Xie6Yu Xie7Yu Xie8Yuting Tan9Yuting Tan10Yuting Tan11Benling Qi12Lijuan Bai13Jingjing Wu14Min Cheng15Xiang Wang16Qing Lv17Qing Lv18Qing Lv19Jing Wang20Jing Wang21Jing Wang22Mingxing Xie23Mingxing Xie24Mingxing Xie25Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaHubei Province Clinical Research Center for Medical Imaging, Wuhan, ChinaHubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaHubei Province Clinical Research Center for Medical Imaging, Wuhan, ChinaHubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaHubei Province Clinical Research Center for Medical Imaging, Wuhan, ChinaHubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaHubei Province Clinical Research Center for Medical Imaging, Wuhan, ChinaHubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaDepartment of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaHubei Province Clinical Research Center for Medical Imaging, Wuhan, ChinaHubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaHubei Province Clinical Research Center for Medical Imaging, Wuhan, ChinaHubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaDepartment of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaHubei Province Clinical Research Center for Medical Imaging, Wuhan, ChinaHubei Province Key Laboratory of Molecular Imaging, Wuhan, ChinaBackgroundIn chronic coronary syndrome (CCS), assessing myocardial ischemia is difficult due to its variable severity. Myocardial mechanical parameters are helpful in ischemia detection. This study investigates the use of non-invasive myocardial work (MW) for ischemia detection and risk assessment in CCS patients.MethodThe study included 115 patients (70 men, mean age 61 years) with suspected or diagnosed CCS in the derivation cohort and 62 patients in the validation cohort. All patients underwent regadenoson stress echocardiography, with early ischemia indicated by coronary flow velocity reserve (CFVR) <2.5. The patients were categorized based on CFVR, and logistic regression was used to assess the association between myocardial work (MW) and ischemia. Model performance was evaluated for accuracy, prediction, and practicality. The risk stratification thresholds were set by sensitivity and specificity.ResultsOf the 115 patients, 48 (41.74%) had myocardial ischemia. MW was more sensitive in detecting ischemia than global longitudinal strain. Multivariate analysis showed that global constructive work reserve (△GCW) was independently correlated with CFVR, with the highest AUC (0.777). A model including △GCW and hemoglobin identified ischemia with a C-index of 0.844 in the derivation cohort and 0.82 in the validation cohort, allowing calculation of the probability of ischemia in CCS. Risk levels were defined by probabilities of 20% (low) and 70% (high).ConclusionThe incorporation of △GCW and hemoglobin into the prediction model enhances its ability to estimate myocardial ischemia risk. △GCW offered higher sensitivity and incremental diagnostic value in detecting myocardial ischemia in the heterogeneous CCS population.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1598453/fullchronic coronary syndromemyocardial ischemiamyocardial workstress echocardiographycoronary flow velocity reserve |
| spellingShingle | Ruohan Zhao Ruohan Zhao Ruohan Zhao Jing Zhang Jing Zhang Jing Zhang Yu Xie Yu Xie Yu Xie Yuting Tan Yuting Tan Yuting Tan Benling Qi Lijuan Bai Jingjing Wu Min Cheng Xiang Wang Qing Lv Qing Lv Qing Lv Jing Wang Jing Wang Jing Wang Mingxing Xie Mingxing Xie Mingxing Xie Reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndrome Frontiers in Cardiovascular Medicine chronic coronary syndrome myocardial ischemia myocardial work stress echocardiography coronary flow velocity reserve |
| title | Reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndrome |
| title_full | Reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndrome |
| title_fullStr | Reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndrome |
| title_full_unstemmed | Reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndrome |
| title_short | Reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndrome |
| title_sort | reserve of global constructive work for early diagnosis of myocardial ischemia and risk stratification in chronic coronary syndrome |
| topic | chronic coronary syndrome myocardial ischemia myocardial work stress echocardiography coronary flow velocity reserve |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1598453/full |
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