Author(s): Reyhaneh Zavar, Hakimeh Sadeghian, Masoumeh Lotfi-Tokaldany, Mohammad Moein Ashrafi, Mahmood Sheikh Fathollahi, Afsaneh Sadeghian
I
ntroduction:
Myocardial longitudinal tissue velocity imaging and strain rate imaging
indices may have a role in the prediction of significant proximal stenosis of left anterior
descending by echocardiography.
Materials and Methods:
Total 20 patients with proximal
left anterior descending stenosis >70% by angiography and ejection fraction ≥50%, without
wall motion abnormality at resting echo (stenotic group) and 20 angiographically normal
coronaries subjects with normal echocardiography (non-stenotic group) were included in
the study. Strain rate imaging and tissue velocity imaging were performed in nine segments
of the left anterior descending territory at rest. Parameters of interest included: peak systolic
strain (%), strain rate (Second
-1
), and peak systolic velocity (Sm, cm/s).
Results
:
Overal
mean systolic strain and strain rate showed a significant reduction in the stenotic group
compared to non-stenotic group (
P
<0.001), while the mean Sm had no significant difference.
A segment-by-segment comparison revealed a reduction of systolic strain in 4/9 (two apical
and two anteroseptal) and strain rate in 5/9 (three apical, septal, and anteroseptal midportion)
in the stenotic group (
P
<0.05). Both systolic strain and strain rate showed a significant
reduction in three segments: anterior-apical, lateral-apical, and anteroseptal midportion.
Conclusion
: There is an overall reduction in the mean systolic strain and strain rate in the
segments of left anterior descending territory with significant proximal stenosis and normal
wall motion at rest and an acceptable specificity and sensitivity of strain rate imaging for the
detection of stenosis in these segments.