Incremental value of 2-dimensional speckle tracking strain imaging to wall motion analysis for detection of coronary artery disease in patients undergoing dobutamine stress echocardiography

Ng, Arnold C. T., Sitges, Marta, Pham, Phuong N., Tran, Da T., Delgado, Victoria, Bertini, Matteo, Nucifora, Gaetano, Vidaic, Jane, Allman, Christine, Holman, Eduard R., Bax, Jeroen J. and Leung, Dominic Y. (2009) Incremental value of 2-dimensional speckle tracking strain imaging to wall motion analysis for detection of coronary artery disease in patients undergoing dobutamine stress echocardiography. American Heart Journal, 158 5: 836-844. doi:10.1016/j.ahj.2009.09.010


Author Ng, Arnold C. T.
Sitges, Marta
Pham, Phuong N.
Tran, Da T.
Delgado, Victoria
Bertini, Matteo
Nucifora, Gaetano
Vidaic, Jane
Allman, Christine
Holman, Eduard R.
Bax, Jeroen J.
Leung, Dominic Y.
Title Incremental value of 2-dimensional speckle tracking strain imaging to wall motion analysis for detection of coronary artery disease in patients undergoing dobutamine stress echocardiography
Journal name American Heart Journal   Check publisher's open access policy
ISSN 0002-8703
1097-6744
Publication date 2009-11
Sub-type Article (original research)
DOI 10.1016/j.ahj.2009.09.010
Volume 158
Issue 5
Start page 836
End page 844
Total pages 9
Place of publication Philadelphia, United States
Publisher Mosby
Language eng
Formatted abstract
Background: Interpretation of dobutamine stress echocardiogram (DSE) is often subjective and requires expert training. The purposes of this study was to determine optimal cutoff values for longitudinal, circumferential, and radial strains at peak
DSE for detection of significant stenoses on coronary angiography and to investigate incremental value of combining strain measurements to wall motion analysis.

Methods: In this multicenter study, 102 patients underwent concomitant DSE and coronary angiography. Optimal cutoff values for mean global longitudinal (−20%), global circumferential (−26%), and mean radial (50%) strains at peak stress for detection of significant stenoses on coronary angiography were determined in a derivation group (n = 62) and tested in a prospectively recruited validation group (n = 40).

Results: Respective sensitivities for longitudinal, circumferential, radial strains, and expert wall motion score index (WMSI) were 84.2%, 73.9%, 78.3%, and 76%; respective specificities were 87.5%, 78.6%, 57.1%, and 92.9%; and respective accuracies were 85.2%, 75.7%, 70.3%, and 82.1%. Longitudinal strain analysis had comparable accuracy to WMSI (P =.70). However, combination longitudinal strain and WMSI had the highest sensitivity, specificity, and accuracy (100%, 87.5%, and 96.3% respectively), and its diagnostic accuracy was incremental to either longitudinal strain (P = .034) or WMSI alone (P = .008).

Conclusion: Longitudinal strain analysis had higher diagnostic accuracy than circumferential and radial strains and was comparable to WMSI for detection of significant coronary artery disease. However, combination longitudinal strain and WMSI resulted in significant incremental increase in diagnostic accuracy.
Keyword Myocardial deformation
Contractile reserve
Inducible ischemia
Validation
Heart
Index
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 30 Apr 2013, 11:24:51 EST by Dr Chin Tse Arnold Ng on behalf of Scholarly Communication and Digitisation Service