Applicability of Longitudinal Strain of Left Ventricle in Unstable Angina

Arq Bras Cardiol. 2018 Apr;110(4):354-361. doi: 10.5935/abc.20180062.
[Article in Portuguese, English]

Abstract

Background: Unstable angina (UA) is a common cause of hospital admission; risk stratification helps determine strategies for treatment.

Objective: To determine the applicability of two-dimensional longitudinal strain (SL2D) for the identification of myocardial ischemia in patients with UA.

Methods: Cross-sectional, descriptive, observational study lasting 60 days. The sample consisted of 78 patients, of which fifteen (19.2%) were eligible for longitudinal strain analysis. The value of p < 0.05 was considered significant.

Results: The group of ineligible patients presented: a lower proportion of women, a higher prevalence of diabetes mellitus (DM), use of ASA, statins and beta-blockers and larger cavity diameters. The main causes of non-applicability were: presence of previous infarction (56.4%), previous CTA (22.1%), previous MRI (11.5%) or both (16.7%) and the presence of specific electrocardiographic abnormalities (12.8%). SL2D assessment revealed a lower global strain value in those with stenosis greater than 70% in some epicardial coronary arteries (17.1 [3.1] versus 20.2 [6.7], with p = 0.014). Segmental strain assessment showed an association between severe CX and RD lesions with longitudinal strain reduction of lateral and inferior walls basal segments; (14 [5] versus 21 [10], with p = 0.04) and (12.5 [6] versus 19 [8], respectively).

Conclusion: There was very low SL2D applicability to assess ischemia in the studied population. However, the global strain showed a correlation with the presence of significant coronary lesion, which could be included in the UA diagnostic arsenal in the future.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Angina, Unstable / diagnostic imaging*
  • Angina, Unstable / physiopathology*
  • Blood Pressure / physiology
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / physiopathology
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology
  • Cross-Sectional Studies
  • Echocardiography / methods*
  • Electrocardiography / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • ROC Curve
  • Reference Values
  • Reproducibility of Results
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Stroke Volume / physiology
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / physiopathology*