Evaluation Of Adenosine Stress Two-dimensional Strain Echocardiography And Coronary Flow Reserve Value In The Diagnosis Of Coronary Heart Disease

Aims: To study the security feasibility and accuracy of two-dimensional (2D)-strain in patients undergoing adenosine stress echocardiography and coronary angiography. We compared the correlation between 2D-SR and CFVR and the difference of their accuracy.Methods: 46 patients who had chest pain and would been underwent coronary angiography were included. Coronary artery disease≥70% (diameter stenosis) were divided into group B, and others were group A . 2D-SR was obtained in three apical views at rest and peak stress. The coronary flow velocity was measured in the distal LAD in diastole, and CFVR were calculated by the ratio of velocity in systole and diastole. 2D-SR was measured off-line. We compared the difference between rest and peak stress and between significant coronary disease segments and non-significant disease segments. Accuracy was analyzed through receiver operating characteristic (ROC) curves.Results: The average 2D-SR at rest in segments of patients with significant CAD were lower than in segments of patients without significant CAD (p<0.01). The average 2D-SR at peak stress in non-ischemia segments of patients were higher than at rest (p<0.01). The accuracy of 2D-SR at peak stress was higher than at rest, according area under the roc curve (AUC). The optimal segments that reflect LAD, RCA and LCX were apical septum, mid inferior and basal posterior. AUCs at peak stress were 0.95, 0.93 and 0.90, and cut-offs were -1.50,-1.41 and -1.25/s. The dependability between CRVR and 2D-SR of LAD is significant (r=0.8, p<0.001), but there was no significant difference between the AUCs of them(0.93 VS 0.95, p=0.05).Conclusions: Measurement of speckle tracking strain during adenosine stress echocardiography is non-invasive, safe, feasible, and has good accuracy. There was significant dependability between CFVR and 2D-SR of LAD, but no significant difference between the accuracy of them. Speckle tracking technique may be reduced by measuring 2D-SR of optimal segments in practice.