Myocardial Layer‐Specific Longitudinal Strain for Identification of the Culprit Vessel in Elderly Patients With NSTE‐ACS

Volume regulation graph (VRG) for 3 data sets (squares) referring to different degrees of coronary stenosis. Associated averaged data for patient cohorts are identified and presented: no significant stenosis, significant stenosis and occlusion. The corresponding data for group average end-systolic volume (ESV) and end-diastolic volume (EDV) are shown, and they appear in ascending order. As average ESV and EDV seem to increase in a pari passu fashion (green line and regression equation), their ratio (reflected by ejection fraction, EF) does not appreciably vary. Maximum EF is indicated by the red line, and minimum EF by the blue line, without significant difference. Based on published data. Also presented are average data for various other studies that employ territorial longitudinal strain (TLS) to detect a culprit vessel. Inset (green color): survey of various metrics used to evaluate severity of a coronary stenosis or detection of culprit vessel, including percentage arterial diameter reduction (% D), left ventricular EF (LVEF), fractional flow reserve (FFR), global longitudinal strain (GLS), TLS, and wall motion score index (WMSI).