Diagnostic Accuracy of 2D Speckle-Tracking Echocardiography for Detecting Coronary Artery Stenosis in Patients with Preserved Ejection Fraction

Abstrak / Ringkasan

Background: Two-dimensional speckle-tracking echocardiography can reveal subclinical myocardial dysfunction in patients with preserved left-ventricular ejection fraction. This study aimed to determine whether global and vessel-specific longitudinal strain metrics are associated with angiographically confirmed coronary artery stenosis.Methods: In a retrospective cross-sectional study at Azadi Teaching Hospital, 90 adults with preserved LVEF (≥ 55%) underwent resting 2D-STE and invasive coronary angiography. VMS/VMSR were computed for LAD, RCA, and LCX territories; GLS/GLSR were calculated for the left ventricle. Territory-level differences used linear regression with patient-clustered errors.Results: Nearly half (48.9%) had stenosis. Territories with significant stenosis showed worse deformation, significant for LAD VMS, RCA VMSR, and LCX VMS. Territory-level discrimination was modest, best with RCA VMSR and LCX VMS. Patient-level global metrics were lower with significant stenosis. Age showed no correlation; hypertension impaired strain, and diabetes was associated with a borderline lower GLSR.Conclusion: In patients with preserved EF, 2D-STE particularly territorial strain metrics maps to angiographic stenosis and provides incremental, localization-oriented information, while global indices show moderate discrimination.

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