Three-Dimensional Speckle Tracking Echocardiography for Detection of Acute Coronary Occlusions in Non-ST-Elevation Acute Coronary Syndrome Patients
<b>Objectives</b>: This study aimed to evaluate the ability of three-dimensional (3D) speckle tracking echocardiography (STE) to detect acute coronary occlusions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and its potential diagnostic advantage over two-d...
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MDPI AG
2025-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/15/15/1864 |
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| author | Thomas M. Stokke Kristina H. Haugaa Kristoffer Russell Thor Edvardsen Sebastian I. Sarvari |
| author_facet | Thomas M. Stokke Kristina H. Haugaa Kristoffer Russell Thor Edvardsen Sebastian I. Sarvari |
| author_sort | Thomas M. Stokke |
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| description | <b>Objectives</b>: This study aimed to evaluate the ability of three-dimensional (3D) speckle tracking echocardiography (STE) to detect acute coronary occlusions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and its potential diagnostic advantage over two-dimensional (2D) STE. <b>Methods</b>: Fifty-six patients with NSTE-ACS (mean age 64 ± 11 years; 80% male) underwent 2D and 3D transthoracic echocardiography prior to coronary angiography. Global longitudinal strain (GLS), global circumferential strain (GCS), and 3D ejection fraction (EF) were analyzed. Acute coronary occlusion was defined as TIMI flow 0–1 in the presumed culprit artery. <b>Results</b>: Acute coronary occlusion was present in 16 patients (29%). Patients with occlusion had significantly more impaired strain compared to those without: 3D GLS (−12.5 ± 2.7% vs. −15.5 ± 2.1%, <i>p</i> < 0.001), 2D GLS (−12.6 ± 2.8% vs. −15.6 ± 2.0%, <i>p</i> < 0.001), 3D GCS (−24.8 ± 4.4% vs. −27.8 ± 4.3%, <i>p</i> = 0.02), and 2D GCS (−18.1 ± 5.5% vs. −22.9 ± 4.7%, <i>p</i> = 0.002). In contrast, 3D EF did not differ significantly between groups (52.5 ± 4.7% vs. 54.7 ± 5.7%, <i>p</i> = 0.16). Receiver operating characteristic analysis showed that 3D and 2D GLS had the highest diagnostic performance (AUCs 0.81 and 0.78), while 3D EF had the lowest (AUC 0.61). Feasibility was lower for 3D STE (86%) than for 2D longitudinal strain (95%, <i>p</i> = 0.03). <b>Conclusions</b>: Both 3D and 2D GLS showed higher diagnostic accuracy than 3D EF in identifying acute coronary occlusion in NSTE-ACS patients. While 3D STE enables simultaneous assessment of multiple parameters, it did not offer incremental diagnostic value over 2D STE and had lower feasibility. |
| format | Article |
| id | doaj-art-ec06646893ad4a468d90ad677fd7ca44 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-07-01 |
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| series | Diagnostics |
| spelling | doaj-art-ec06646893ad4a468d90ad677fd7ca442025-08-20T03:36:34ZengMDPI AGDiagnostics2075-44182025-07-011515186410.3390/diagnostics15151864Three-Dimensional Speckle Tracking Echocardiography for Detection of Acute Coronary Occlusions in Non-ST-Elevation Acute Coronary Syndrome PatientsThomas M. Stokke0Kristina H. Haugaa1Kristoffer Russell2Thor Edvardsen3Sebastian I. Sarvari4ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, 0424 Oslo, NorwayProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, 0424 Oslo, NorwayProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, 0424 Oslo, NorwayProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, 0424 Oslo, NorwayProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, 0424 Oslo, Norway<b>Objectives</b>: This study aimed to evaluate the ability of three-dimensional (3D) speckle tracking echocardiography (STE) to detect acute coronary occlusions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and its potential diagnostic advantage over two-dimensional (2D) STE. <b>Methods</b>: Fifty-six patients with NSTE-ACS (mean age 64 ± 11 years; 80% male) underwent 2D and 3D transthoracic echocardiography prior to coronary angiography. Global longitudinal strain (GLS), global circumferential strain (GCS), and 3D ejection fraction (EF) were analyzed. Acute coronary occlusion was defined as TIMI flow 0–1 in the presumed culprit artery. <b>Results</b>: Acute coronary occlusion was present in 16 patients (29%). Patients with occlusion had significantly more impaired strain compared to those without: 3D GLS (−12.5 ± 2.7% vs. −15.5 ± 2.1%, <i>p</i> < 0.001), 2D GLS (−12.6 ± 2.8% vs. −15.6 ± 2.0%, <i>p</i> < 0.001), 3D GCS (−24.8 ± 4.4% vs. −27.8 ± 4.3%, <i>p</i> = 0.02), and 2D GCS (−18.1 ± 5.5% vs. −22.9 ± 4.7%, <i>p</i> = 0.002). In contrast, 3D EF did not differ significantly between groups (52.5 ± 4.7% vs. 54.7 ± 5.7%, <i>p</i> = 0.16). Receiver operating characteristic analysis showed that 3D and 2D GLS had the highest diagnostic performance (AUCs 0.81 and 0.78), while 3D EF had the lowest (AUC 0.61). Feasibility was lower for 3D STE (86%) than for 2D longitudinal strain (95%, <i>p</i> = 0.03). <b>Conclusions</b>: Both 3D and 2D GLS showed higher diagnostic accuracy than 3D EF in identifying acute coronary occlusion in NSTE-ACS patients. While 3D STE enables simultaneous assessment of multiple parameters, it did not offer incremental diagnostic value over 2D STE and had lower feasibility.https://www.mdpi.com/2075-4418/15/15/1864three-dimensional echocardiographytwo-dimensional echocardiographyglobal longitudinal strainglobal circumferential strainnon-ST-elevation acute coronary syndromecoronary occlusion |
| spellingShingle | Thomas M. Stokke Kristina H. Haugaa Kristoffer Russell Thor Edvardsen Sebastian I. Sarvari Three-Dimensional Speckle Tracking Echocardiography for Detection of Acute Coronary Occlusions in Non-ST-Elevation Acute Coronary Syndrome Patients Diagnostics three-dimensional echocardiography two-dimensional echocardiography global longitudinal strain global circumferential strain non-ST-elevation acute coronary syndrome coronary occlusion |
| title | Three-Dimensional Speckle Tracking Echocardiography for Detection of Acute Coronary Occlusions in Non-ST-Elevation Acute Coronary Syndrome Patients |
| title_full | Three-Dimensional Speckle Tracking Echocardiography for Detection of Acute Coronary Occlusions in Non-ST-Elevation Acute Coronary Syndrome Patients |
| title_fullStr | Three-Dimensional Speckle Tracking Echocardiography for Detection of Acute Coronary Occlusions in Non-ST-Elevation Acute Coronary Syndrome Patients |
| title_full_unstemmed | Three-Dimensional Speckle Tracking Echocardiography for Detection of Acute Coronary Occlusions in Non-ST-Elevation Acute Coronary Syndrome Patients |
| title_short | Three-Dimensional Speckle Tracking Echocardiography for Detection of Acute Coronary Occlusions in Non-ST-Elevation Acute Coronary Syndrome Patients |
| title_sort | three dimensional speckle tracking echocardiography for detection of acute coronary occlusions in non st elevation acute coronary syndrome patients |
| topic | three-dimensional echocardiography two-dimensional echocardiography global longitudinal strain global circumferential strain non-ST-elevation acute coronary syndrome coronary occlusion |
| url | https://www.mdpi.com/2075-4418/15/15/1864 |
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