الفهرس 
Obstructive Coronary Artery DiseaseOnly 14 pages are availabe for public view
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Abstract
Noninvasive identification of patients with coronary artery disease (CAD) remains a clinical challenge despite the widespread use, and possible overuse, of imaging and provocative testing; more than 50% of patients currently referred to coronary angiography show normal or non-obstructive CAD (1)
Recently, the 2-dimensional Speckle Tracking Echocardiography (STE) and its derivatives, including strain and strain rate imaging have been gained substantial clinical interest to surmount those limitations. The strain and strain rate imaging methods represent the magnitude and rate of myocardial deformations, respectively. Based on the numerous studies, the majority of them support the existence of a significant correlation between the longitudinal strain and CAD. (4)
Current evidence supports the use of GLS in the detection of moderate to severe obstructive CAD in symptomatic patients. GLS may complement existing diagnostic algorithms and act as an early adjunctive marker of cardiac ischemia. (5)
We aimed to assess whether the diagnostic accuracy of 2D-STE global and segmental longitudinal strain (LS) measured at rest may compare to the parameters of coronary angiography to predict obstructive CAD.
The study was carried out on 100 patients admitted to the department of cardiology, Menoufia University Hospital.
All patients enrolled in this study were subjected to the following: -
1. Full medical history and clinical examination.
2. ECG to detect CAD.
3. Trans thoracic echocardiography to detect wall motion abnormalities and LVEDD, LVESD and LVEF.
4. 2D speckle tracking echocardiography to detect peak longitudinal systolic strain (PLSS) and strain rate at peak systole (SRs), early systole (SRe) and late diastole (SRa) for all LV walls for basal, mid and apical segments.
5. Coronary angiography to detect severity of coronary artery disease by Gensini score and comparing it with STE results.
6. Our subjects were divided into three groups, group I patient with chronic stable angina and unstable angina, group II patients with NSTEMI and STEMI and group III controls.
The characteristics of the studied groups include the followings:
The mean age for studied groups was 52.20±11.83, 51.97±14.53 and 52.75±10.75 respectively with non-significant difference in between the three groups
There was a significant difference between group II and control as regarding LVESD with p value 0.008 and also a significant difference in between the three groups as regarding EF% with p values 0.019, <0.001 and 0.011 respectively
There was a significant difference among group I and controls group II and controls as regarding average LV global peak systolic strain% with p value <0.001for both, meanwhile there was non-significant difference in between group I and group II with p value 0.323
As regarding all strain rate parameters (SRs, SRe and SRa) it was significant when comparing group I and group II with controls with p values 0.001 for all.