Layer-specific strain in dipyridamole stress echo: A new tool for the diagnosis of microvascular angina

Autor:	Sergio Mondillo, Stefano Lunghetti, Giulia Elena Mandoli, Felice Crudele, Matteo Cameli, Simona Minardi
Rok vydání:	2018
Předmět:	Male medicine.medical_specialty Heart Ventricles Vasodilator Agents Ischemia Strain (injury) 030204 cardiovascular system & hematology Ventricular Function Left Coronary artery disease layer-specific strain 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Stress Echocardiography Humans Circumferential strain Radiology Nuclear Medicine and imaging 030212 general & internal medicine Aged Retrospective Studies coronary artery disease dipyridamole stress echo microvascular angina speckle tracking business.industry Reproducibility of Results Microvascular angina Dipyridamole Middle Aged medicine.disease ROC Curve Stress Echo Cardiology Female Cardiology and Cardiovascular Medicine business Echocardiography Stress Follow-Up Studies medicine.drug
Zdroj:	Echocardiography. 35:2005-2013
ISSN:	0742-2822
DOI:	10.1111/echo.14180
Popis:	Background Dipyridamole stress echocardiography (DSE) represents a fundamental test in patients with suspected coronary artery disease (CAD). The diagnosis of microvascular disease is still challenging. We aimed to determine the diagnostic value of left ventricular (LV) layer-specific longitudinal (LS) and circumferential strain (CS) by Speckle Tracking in detecting CAD during DSE and to study if they can help in discriminate between a negative echo and a suspected microvascular angina. Methods and results We enrolled 66 patients with known or suspected CAD. All underwent standard DSE. We identified 3 groups according to the result of DSE (36 negative DSE, 19 positive DSE, 11 indicatives for microvascular disease). Wall motion score index, global LV LS and CS (global longitudinal strain [GLS] and global circumferential strain [GCS]), and layer-specific LV LS and CS were measured at rest and peak stress. The Delta between rest and peak stress values was calculated. GLS increased after injection in negative DSE and microvascular disease while reducing in positive DSE. Endocardial GCS and transmural GCS values were stable in microvascular disease while increasing significantly in negative DSE, helping in the diagnosis. The specific analysis of endocardial LS showed the most powerful difference between healthy and macrovascular CAD patients, both for LS and CS. Conclusions Global circumferential strain can be a new valuable added tool in the echocardiographic diagnosis of microvascular disease. Endocardial GLS is the best indicator of an altered wall deformation in the presence of macrovascular ischemia.
Databáze:	OpenAIRE
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