The value of 3-dimensional longitudinal strain in the evaluation of complex coronary lesions in non-ST-segment elevation acute coronary syndrome patient.
The aim of this study is to investigate the value of 3-dimensional global peak longitudinal strain (GPLS) derived from the 3-dimensional speckle-tracking echocardiography (3D-STE) in the diagnosis of the complex non-ST-segment elevation acute coronary syndromes (NSTE-ACS) by comparing GPLS to the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score.A total of 59 inpatients with NSTE-ACS in our hospital between October 2014 and January 2015 were enrolled into our study. All these subjects underwent the coronary angiography (CAG) and 3D-STE examination. The results of CAG were used to calculate the SYNTAX scores in each subject. The GPLS was assessed with speckle-tracking analysis using the dedicated software developed by GE Healthcare (Horten, Norway).We grouped all subjects according to the SYNTAX scores. A total of 23 patients (39%) were grouped as complex NSTE-ACS in our experiment. In our analysis, the values of GPLS significantly decreased from low SYNTAX scores to intermediate or high SYNTAX scores (-14.0 ± 2.7% and -9.5 ± 2.8%, respectively, P < 0.001). Multivariate regression analysis showed that GPLS and diabetes mellitus were independent predictors for complex NSTE-ACS. The area under the receiver operator characteristic curve (AUC) for GPLS to evaluate patients with complex NSTE-ACS was 0.882 (95% confidence interval [CI], 0.797-0.967, P < 0.001) with an optimal cutoff value of -11.76% (sensitivity 82.6% and specificity 83.3%). The evaluative value of the adjusted AUC for evaluating patients with complex NSTE-ACS improved after inclusion of GPLS (C statistics, 0.827-0.948, P < 0.001).The value of GPLS is significantly associated with the complexity of coronary artery lesions, according to SYNTAX score. Therefore, our study indicates that GPLS could be reproducible and efficient to evaluate the complex coronary artery disease in NSTE-ACS patients.
aDepartment of Cardiology, Guangzhou General Hospital of Guangzhou Military Region, PLA, Guangzhou bThe Second Affiliated Hospital of Shantou University Medical College, Shantou cInstitute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Shenzhen dDepartment of Ultrasound, Guangzhou General Hospital of Guangzhou Military Region, PLA eSouthern Medical University, Guangzhou, China.
Zekun
Z
Cai
Jianwei
J
Dai
Dan
D
Wu
Jian
J
Qiu
Jun
J
Ma
Guoying
G
Li
Wei
W
Zhu
Hongqiang
H
Lei
Wenhua
W
Huang
Heye
H
Zhang
Lin
L
Xu
D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D017023:Coronary Angiography; D003920:Diabetes Mellitus / Q000453:epidemiology; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072658:Non-ST Elevated Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D012737:Sex Factors
Am J Cardiol. 2012 Jan 15;109(2):180-6
22019208
Can J Cardiol. 2006 Sep;22(11):935-7
16971978
Circ Cardiovasc Imaging. 2014 Jan;7(1):58-65
24186963
J Am Coll Cardiol. 2014 May 27;63(20):2111-8
24632279
Circ J. 2009 Jun;73(6):1105-10
19359810
Arterioscler Thromb Vasc Biol. 2006 Jan;26(1):206-11
16269666
Echocardiography. 2013 Jan;30(1):88-105
23297852
Am J Pathol. 1980 Mar;98(3):663-80
7361850
N Engl J Med. 2009 Mar 5;360(10):961-72
19228612
Eur Heart J. 2011 Dec;32(23):2999-3054
21873419
Am Heart J. 2009 Jan;157(1):102.e1-5
19081404
J Am Coll Cardiol. 2006 Jul 18;48(2):281-6
16843176
Heart Vessels. 2016 Jun;31(6):890-6
25964074
Cardiovasc Interv Ther. 2013 Jan;28(1):16-21
22875747
J Am Coll Cardiol. 2002 Oct 16;40(8):1531-40
12392846
Eur J Echocardiogr. 2009 Jul;10 (5):695-701
19401300
Heart Vessels. 2014 May;29(3):300-7
23666363
JACC Cardiovasc Imaging. 2013 May;6(5):535-44
23582354
EuroIntervention. 2005 Aug;1(2):219-27
19758907
J Am Coll Cardiol. 2011 Jun 14;57(24):2389-97
21658558
Int J Clin Exp Med. 2015 Jun 15;8(6):9412-20
26309603
Circulation. 1978 Jan;57(1):133-6
618380
Am J Cardiol. 2007 Apr 15;99(8):1072-81
17437730
Circ Cardiovasc Interv. 2011 Dec 1;4(6):553-61
22028472
J Am Coll Cardiol. 2014 Dec 23;64(24):e139-228
25260718
PLoS One. 2015 May 15;10(5):e0127044
25978372
Eur Heart J. 2011 Sep;32(17):2125-34
21697170
J Am Coll Cardiol. 2013 Jun 11;61(23 ):2365-73
23563128