title: Transthoracic ultrasonic tissue indices identify patients with severe left anterior descending artery stenosis. Correlation with fractional flow reserve. Pilot study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the potential clinical application of ultrasonic tissue indices, with a focus on systolic strain (SS) and systolic strain rate (SSR) parameters derived from transthoracic echocardiography, in the assessment of left anterior descending artery (LAD) stenosis.
  
  
  METHODS
  The data of 30 patients with significant LAD stenosis were analysed. All patients underwent transthoracic echocardiography to obtain systolic myocardial velocity (Sm), longitudinal SS, and SSR from basal, mid, and apical segments of anterior and inferior walls in two-chamber apical view. Severity of LAD obstruction was measured by means of fractional flow reserve (FFR) during coronary catheterisation.
  
  
  RESULTS
  Systolic velocities, strain, and strain rate measured in basal, middle, and apical segments of the anterior left ventricular (LV) wall were lower when compared to those obtained from the corresponding, i.e. unaffected, inferior LV wall. There was a significant correlation between FFR and the value of SS, SSR characterising the apical LV segment of the anterior wall (r = -0.583, p = 0.01; r = -0.598, p = 0.01, respectively). Moreover, we found significant correlation between FFR and Sm in the mid-segment of the LV anterior wall (r = 0.611, p = 0.009).
  
  
  CONCLUSIONS
  We conclude that SS and SSR obtained from the apical segment of the anterior LV wall may be related to the severity of LAD stenosis.
authors.affiliation: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland. p.dobrowolski@ikard.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Dobrowolski
authors.forename: Mirosław
authors.initials: M
authors.lastname: Kowalski
authors.forename: Justyna
authors.initials: J
authors.lastname: Rybicka
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Lech
authors.forename: Paweł
authors.initials: P
authors.lastname: Tyczyński
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
authors.forename: Piotr
authors.initials: P
authors.lastname: Hoffman
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects
keywords: coronary disease; echocardiography; fractional flow reserve; left anterior descending artery stenosis; systolic strain; systolic strain rate