Prediction of coronary artery stenosis at rest in patients with normal left ventricular wall motion: Segmental analyses using strain imaging diastolic index

Bei Yang, Masao Daimon, Katsuhisa Ishii, Takayuki Kawata, Sakiko Miyazaki, Kuniaki Hirose, Ryoko Ichikawa, Shuo Ju Chiang, Hiromasa Suzuki, Katsumi Miyauchi, Hiroyuki Daida

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

Noninvasive detection of coronary artery stenosis usually requires a stress test in patients without left ventricular (LV) regional wall motion abnormalities (RWMA). In contrast, abnormal regional LV relaxation caused by ischemia may persist beyond recovery from transient ischemia. The aim of the present study was to determine whether segmental analysis of abnormal regional LV relaxation using the strain imaging diastolic index (SI-DI) at rest could predict coronary artery stenosis in the three major vessels in patients without LV dysfunction or RWMA. We performed 2D speckle tracking echocardiography and coronary angiography in 85 patients without RWMA with suspected coronary artery disease. Patients with LV dysfunction or acute coronary syndrome were excluded. Echocardiographic images of the LV were obtained in the apical 2-, 3-, and 4-chamber views and divided into 6 segments. In each segment, SI-DI derived from transverse strain imaging was determined. Forty-eight patients had significant coronary artery stenosis (≥ 70%). The optimal cutoff values of SI-DI were 60.5% in the mid anteroseptal segment for detecting left anterior descending artery stenosis (sensitivity, 83.3%; specificity, 81.1%), 60.5% in the basal anterolateral segment for detecting left circumflex artery stenosis (sensitivity, 80.9%; specificity, 90.3%), and 61.5% in the basal inferior segment for detecting right coronary artery stenosis (sensitivity, 74.1%; specificity, 77.8%). A segmental analysis of SI-DI at rest predicted coronary artery stenosis in the three major vessels in patients without RWMA. This noninvasive method may be useful for detecting coronary artery stenosis without a stress test.

Original languageEnglish
Pages (from-to)266-272
Number of pages7
JournalInternational Heart Journal
Volume54
Issue number5
DOIs
Publication statusPublished - 2013
Externally publishedYes

Keywords

  • Coronary artery disease
  • Echocardiography
  • Strain imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Prediction of coronary artery stenosis at rest in patients with normal left ventricular wall motion: Segmental analyses using strain imaging diastolic index'. Together they form a unique fingerprint.

Cite this