Abstract 11329: Superiority of Assessing Endocardial Strain to Whole Wall Thickness Strain by Dobutamine Stress Echocardiography in the Dectection of Coronary Artery Disease
Background: Myocardial ischemia typically extends from the endocardium to the epicardium. Therefore methods of assessment myocardial functional abnormality at the endocardial layer may permit a more accurate detection of coronary artery disease (CAD) this was testified in the current study with the use of dobutamine stress echocardiography.
Methods: After baseline echocardiographic scans obtained, 40 patients with suspected CAD underwent dobutamine stress echocardiography (peak dose, 40μg/kg/min). Coronary angiography was performed within 3 days after test. Echocardiographic images were post-processed by a layer-specific speckle tracking software (EchoPac Version 113, GE) to measure the peak longitudinal strain (STE-L) at the endocardium, midlayer, and epicardium as well as total wall thickness (STE-W).
Results: Forty patients were enrolled into the study. Among them 22 (mean age of 56 ± 15 years) had significant coronary artery disease (stenosis >70%). This included single-vessel disease at left anterior descending artery (LAD) in 19 patients and triple vessel disease in 3 patients. The other 18 patients had normal coronary angiography. The longitudinal strain at both endocardial layer (-23.6 ± 4.9% vs -31.6 ± 4.9%, p<0.05) and total wall thickness (-18.7 ± 4.4% vs -23.3 ± 4.2%, p-29%, ROC curve area of 0.90, sensitivity of 86 %, specificity of 78%, p -21.8 %, ROC curve area of 0.76, sensitivity of 77%, specificity of 72%, p=0.0004) (Figure).
Conclusion: The use of endocardial layer of longitudinal strain is superior to total wall thickness strain in detecting CAD at the LAD territory.
Author Disclosures: J. Sun: None. Z. Qiao: None. Y. Fan: None. X. Shen: None. H. Zhao: None. J. Pu: None. A. Lee: None. B. He: None. C. Yu: None.
- © 2014 by American Heart Association, Inc.