Role of Left Ventricular Speckle Tracking Imaging in Detection of Coronary Artery Disease in Non-Diabetic Patients

Abstract

This study aimed to determine the role of global longitudinalstrain (GLS) in early diagnosis and detection of severity of coronaryartery disease (CAD) in non-diabetic patients with preservedleft ventricular ejection fraction (EF) without regionalwall motion abnormalities presented with chronic coronary syndrome,and to identify the role of territorial longitudinal strain(TLS) in detection of the affected coronary artery. We enrolled60 non-diabetic patients with suspected CAD who underwentresting echocardiography and speckle tracking imaging andsubsequently coronary angiography then results were correlatedtogether. Patients with family history of CAD (68.3%), hypertension(68.3%), smokers (43.3%), and dyslipidemia (81.6%). Allparticipants had normal left ventricular systolic function withmean EF of 64.02±6.15% and no regional wall motion abnormalitiesat rest. Patients were classified angiographically accordingto the number of the diseased vessels into: 3 vessels disease(43.3%), 1-2 vessels disease (35%), and normal coronaryangiography (21.7%) with GLS mean values of -13.69±1.94%,-15.4±1.74%, and -18.80±2.14%, respectively. There was a negativesignificant correlation between GLS values and the numberof diseased vessels (P=0.001). The values of TLS were significantlylower in myocardial regions supplied by stenotic arteries thanthose supplied by non-stenotic arteries. Mean TLS values forstenotic left anterior descending, left circumflex, and right coronaryarteries were -15.51±3.19, -13.06±2.90, -13.27±2.60 withP=0.011, 0.001, and 0.001, respectively. Speckle tracking derivedGLS is an effective non-invasive method in predicting presenceand severity of CAD and in locating the affected vessels basedon the distribution of segments affected in TLS.