Value Of Detecting Severe Multi-vessel Coronary Artery Stenosis Using Three-dimensional Speckle Tracking Echocardiography

Objective:The aim of this study was to assess the value of three-dimensional (3D) speckle tracking echocardiography (STE) for the detection of non-myocardial infarction severe multi-vessel coronary stenosis at the resting state. Methods:38cases with severe multi-vessel coronary stenosis by coronary angiography (Coronary arteriography, CAG); 17cases with severe single-vessel coronary artery stenosis; A control group of 37cases. All patients underwent two dimensional echocardiography and three-dimensional echocardiography, acquisition and storage of heart full volume three-dimensional dynamic map. Image analysis was performed offline after tracking technology of stored full volume three-dimensional dynamic graph using 3D-STE, can be automatically measured left ventricular global longitudinal strain is obtained (Global longitudinal strain, GLS), the global circumferential strain (Global circumferential strain, GCS), the global area of strain (Global area strain, GAS) and the global radial strain (Global radial strain, GRS). Results: In the severe multi-vessel coronary stenosis group, six cases of left anterior descending coronary artery vascular occlusion, eight cases of left circumflex coronary artery occlusion, nine cases of right coronary artery occlusion. In the severe single-vessel coronary stenosis group,14 cases were left anterior descending coronary artery,2 cases were right coronary artery, lease was left circumflex coronary, and in all of this cases, no vessel occlusion was found. All 3D speckle-tracking echocardiographic parameters (GLS, GCS, GAS, and GRS) were significantly decreased compared with the control group (P<0.05); the 3D speckle-tracking echocardiographic parameters of the severe multi-vessel coronary stenosis group were more dramatically decreased. Similar changes were also observed for all four 3D STE parameters in the severe multi-vessel stenosis group than the severe single-vessel coronary stenosis group, whereas only GLS and GAS had statistically significantly decreased (P< 0.05). Receiver operating characteristic curve analysis demonstrated areas under the curve of 0.87 for 3D GLS,0.75 for 3D GCS,0.82 for 3D GAS, and 0.81 for 3D GRS. An optimal 3D GLS cutoff value of magnitude<-11% with 84.2% sensitivity and 3D GAS cutoff value of magnitude<-19% with 91.9% specificity predicted severe multi-vessel coronary stenosis. Conclusions:Global strain by 3D STE is useful to detect severe multi-vessel coronary stenosis, wherein GLS and GAS are more valuable indicators.