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Prediction of Significant Coronary Artery Disease Through Advanced Echocardiography: Role of Non-invasive Myocardial Work

Authors :
Jolanda Sabatino
Salvatore De Rosa
Isabella Leo
Antonio Strangio
Carmen Spaccarotella
Alberto Polimeni
Sabato Sorrentino
Giovanni Di Salvo
Ciro Indolfi
Sabatino, Jolanda
De Rosa, Salvatore
Leo, Isabella
Strangio, Antonio
Spaccarotella, Carmen
Polimeni, Alberto
Sorrentino, Sabato
Di Salvo, Giovanni
Indolfi, Ciro
Source :
Frontiers in Cardiovascular Medicine, Vol 8 (2021), Frontiers in Cardiovascular Medicine
Publication Year :
2021

Abstract

Background: Non-invasive prediction of critical coronary artery stenosis (CAST) in patients with coronary artery disease (CAD) is challenging. Strain parameters can often capture an impairment of regional longitudinal function; however, they are load dependent. A novel non-invasive method to estimate Myocardial Work (MW) has been recently proposed, showing a strong correlation with invasive work measurements. Our aim was to investigate the ability of non-invasive MW to predict the ischaemic risk area underlying a CAST.Methods and Results: The study population comprises 80 individuals: 50 patients with CAST and 30 controls (CTRL). Echocardiography recordings were obtained before coronary angiography to measure global longitudinal strain (GLS), Myocardial Work Index (MWI), Myocardial Constructive Work (MCW), Myocardial Wasted work (MWW), Myocardial Work Efficiency (MWE). Global MWI (p = 0.048), MWE (p < 0.001), and MCW (p = 0.048) at baseline were significantly reduced in patients with CAST compared to controls (p < 0.05). Regional MWE within the myocardial segments underlying the CAST, but not LS, was significantly reduced compared to non-target segments (p < 0.001). At ROC analysis, the diagnostic performance to predict CAST for regional MWE (AUC = 0.920, p < 0.001) was higher compared to both regional post-systolic shortening index (PSI) (AUC = 0.600, p = 0.129) and regional LS (AUC = 0.546, p = 0.469).Conclusions: Non-invasive estimation of MW work indices is able to predict a CAST before invasive angiography.

Details

Language :
English
Database :
OpenAIRE
Journal :
Frontiers in Cardiovascular Medicine, Vol 8 (2021), Frontiers in Cardiovascular Medicine
Accession number :
edsair.doi.dedup.....f347d0722bcdc4e1bc4b119c91b11abf