Correlation between Myocardial Strain by 2D Speckle Tracking Echocardiography and Severity of Coronary Artery Disease by Coronary Angiography in Chronic Stable Angina

Abstract Background CAD is a significant cause of mortality and morbidity, Noninvasive imaging techniques are crucial in the diagnosis and risk stratification of patients with suspected stable angina pectoris. However, invasive coronary angiography remains the gold standard for CAD diagnosis. To enhance patient selection for this procedure, myocardial deformation imaging using strain echocardiography provides a simple and noninvasive method to evaluate LV deformation during myocardial ischemia. Strain echocardiography improves the identification of patients who would benefit from invasive coronary angiography. Objective To correlate between severity of coronary artery disease using Gensini score and 2D speckle-tracking derived LV global longitudinal strain. Patients and Methods The study included 100 patients with symptoms of chronic stable angina. History taking, cardiac examination, full transthoracic echocardiographic study including assessment of left ventricular global longitudinal strain (GLS) using 2D speckle tracking echocardiography and coronary angiography were done for all patients. Results The study concluded that a GLS value of -15% was the optimal cut-off for predicting the presence of significant coronary artery lesions, with a sensitivity of 55.81% and specificity of 82.46%. Correlation analysis revealed a positive correlation between GLS and the Gensini score, indicating that as the Gensini score increased (indicating more severe coronary artery disease), the GLS became less negative. Conclusion GLS has significant correlation with Gensini score and aids in detection of significant CAD in patients with chronic stable angina. Myocardial strain by 2-D speckle tracking echocardiography together with Gensini score assessment correlates with the angiographic severity evaluated by coronary angiography in patients with stable angina with good sensitivity and specificity thus facilitating prediction of presence of significant CAD. Accordingly, this promises to be an efficient, non-invasive diagnostic tool that may facilitate early intervention for patients with CAD and application of preventive or treatment measures for patients with chronic coronary syndrome.