title: Duration of myocardial early systolic lengthening predicts the presence of significant coronary artery disease.
abstract: OBJECTIVE
  This study sought to investigate whether the duration of left ventricular (LV) early systolic lengthening could accurately identify patients with significant coronary artery disease (CAD).
  
  
  BACKGROUND
  Ischemic myocardium with reduced active force will lengthen when LV pressure rises during early systole before onset of systolic shortening.
  
  
  METHODS
  We included 88 patients with suspected CAD referred to elective diagnostic coronary angiography. Two of these patients were excluded from the study due to evidence of previous myocardial infarction on contrast-enhanced magnetic resonance imaging. Speckle tracking echocardiography was performed before coronary angiography and at follow-up scheduled 1 year after revascularization, and global longitudinal strain and duration of average LV early systolic lengthening were recorded.
  
  
  RESULTS
  Forty-three of 86 patients had significant CAD. The duration of early systolic lengthening was significantly prolonged in patients with significant CAD compared with patients without significant coronary artery stenoses (76 ± 37 ms vs. 38 ± 23 ms, p < 0.001). Correspondingly, global systolic strain was significantly lower in patients with CAD (-17.7 ± 3.0% vs. -19.5 ± 2.6%, p = 0.003). Prolonged duration of early systolic lengthening showed the best accuracy in detecting CAD, with an area under the receiver-operating characteristic curve of 0.83. The area under the curve for global strain was 0.68. At 1-year follow-up, the duration of early systolic lengthening was significantly reduced (64 ± 37 ms vs. 76 ± 37 ms, p = 0.041) in the patients treated with revascularization.
  
  
  CONCLUSIONS
  Duration of myocardial early systolic lengthening was prolonged in patients with significant CAD; this might be a useful parameter to identify patients who might benefit from reperfusion therapy.
authors.affiliation: Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Oslo, Norway.
authors.forename: Marit Kristine
authors.initials: MK
authors.lastname: Smedsrud
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sarvari
authors.forename: Kristina H
authors.initials: KH
authors.lastname: Haugaa
authors.forename: Ola
authors.initials: O
authors.lastname: Gjesdal
authors.forename: Stein
authors.initials: S
authors.lastname: Ørn
authors.forename: Lars
authors.initials: L
authors.lastname: Aaberge
authors.forename: Otto A
authors.initials: OA
authors.lastname: Smiseth
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013599:Systole / Q000502:physiology*; D013997:Time Factors