作者
Jolanda Sabatino, Salvatore De Rosa, Isabella Leo, Antonio Strangio, Carmen Spaccarotella, Alberto Polimeni, Sabato Sorrentino, Giovanni Di Salvo, Ciro Indolfi
发表日期
2021/8/24
期刊
Frontiers in Cardiovascular Medicine
卷号
8
页码范围
719603
出版商
Frontiers Media SA
简介
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.
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J Sabatino, S De Rosa, I Leo, A Strangio… - Frontiers in Cardiovascular Medicine, 2021