title: Diagnostic accuracy of myocardial deformation indices for detecting high risk coronary artery disease in patients without regional wall motion abnormality.
abstract: BACKGROUND
  The prediction of coronary artery disease (CAD) by conventional echocardiographic measurements is principally based on the estimation of ejection fraction and regional wall motion abnormality (RWMA). This study aimed to determine whether strain echocardiography of left ventricle measured by velocity vector imaging (VVI) method could detect patients with a high-risk CAD.
  
  
  METHODS
  In a prospective study, a total of 119 consecutive patients who were assessed for eligibility were categorized into three groups: (1) without CAD as normal (n=59), (2) 1- or 2-vessel disease as low-risk (n=29), and (3) left main and/or 3-vessel disease as high-risk (n=31). The peaks of systolic strain and strain rate from 18 curves of apical views were averaged as global longitudinal strain and strain rate (GLS and GLSR), respectively; the 6 systolic peaks of strain and strain rate at base- and mid-ventricular of short axis views were averaged as mean radial strain rate (MRSR).
  
  
  RESULTS
  GLS, GLSR, and basal MRSR of left ventricle were significantly lower in the high-risk group (P=0.047, P=0.004 and P=0.030, respectively). Receiver operating characteristics curve showed that the optimal values of GLS, GLSR, and basal MRSR for detecting the severe CAD were -17%, -1 s(-1), and 1.45 s(-1) with the sensitivities of 77%, 71%, and 71% and the specificities of 63%, 67%, and 62%, respectively.
  
  
  CONCLUSIONS
  Decrements in the GLS, GLSR, and basal MRSR of the left ventricle can detect the high-risk CAD cases among patients without RWMA at rest.
authors: Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences Urmia, Iran.
authors: Alireza
authors: A
authors: Rostamzadeh
authors: Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences Tehran, Iran.
authors: Maryam
authors: M
authors: Shojaeifard
authors: Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences Urmia, Iran.
authors: Yousef
authors: Y
authors: Rezaei
authors: Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Sarab, Iran.
authors: Kasra
authors: K
authors: Dehghan
keywords: Coronary artery disease; global longitudinal strain; global longitudinal strain rate; mean radial strain rate; regional wall motion abnormality