Prediction of Significant Coronary Artery Disease Through Advanced Echocardiography: Role of Non-invasive Myocardial Work
Background: Non-invasive prediction of critical coronary artery stenosis (CAST) in patients with coronary artery disease (CAD) is challenging. Strain parameters can often capture an impairment of regional longitudinal function; however, they are load dependent. A novel non-invasive method to estimat...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.719603/full |
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| author | Jolanda Sabatino Jolanda Sabatino Jolanda Sabatino Salvatore De Rosa Salvatore De Rosa Isabella Leo Antonio Strangio Carmen Spaccarotella Carmen Spaccarotella Alberto Polimeni Alberto Polimeni Sabato Sorrentino Sabato Sorrentino Giovanni Di Salvo Ciro Indolfi Ciro Indolfi Ciro Indolfi |
| author_facet | Jolanda Sabatino Jolanda Sabatino Jolanda Sabatino Salvatore De Rosa Salvatore De Rosa Isabella Leo Antonio Strangio Carmen Spaccarotella Carmen Spaccarotella Alberto Polimeni Alberto Polimeni Sabato Sorrentino Sabato Sorrentino Giovanni Di Salvo Ciro Indolfi Ciro Indolfi Ciro Indolfi |
| author_sort | Jolanda Sabatino |
| collection | DOAJ |
| description | Background: Non-invasive prediction of critical coronary artery stenosis (CAST) in patients with coronary artery disease (CAD) is challenging. Strain parameters can often capture an impairment of regional longitudinal function; however, they are load dependent. A novel non-invasive method to estimate Myocardial Work (MW) has been recently proposed, showing a strong correlation with invasive work measurements. Our aim was to investigate the ability of non-invasive MW to predict the ischaemic risk area underlying a CAST.Methods and Results: The study population comprises 80 individuals: 50 patients with CAST and 30 controls (CTRL). Echocardiography recordings were obtained before coronary angiography to measure global longitudinal strain (GLS), Myocardial Work Index (MWI), Myocardial Constructive Work (MCW), Myocardial Wasted work (MWW), Myocardial Work Efficiency (MWE). Global MWI (p = 0.048), MWE (p < 0.001), and MCW (p = 0.048) at baseline were significantly reduced in patients with CAST compared to controls (p < 0.05). Regional MWE within the myocardial segments underlying the CAST, but not LS, was significantly reduced compared to non-target segments (p < 0.001). At ROC analysis, the diagnostic performance to predict CAST for regional MWE (AUC = 0.920, p < 0.001) was higher compared to both regional post-systolic shortening index (PSI) (AUC = 0.600, p = 0.129) and regional LS (AUC = 0.546, p = 0.469).Conclusions: Non-invasive estimation of MW work indices is able to predict a CAST before invasive angiography. |
| first_indexed | 2024-12-17T13:23:13Z |
| format | Article |
| id | doaj.art-3ef30fdfaaa4403f8680eb343b538f30 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-17T13:23:13Z |
| publishDate | 2021-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-3ef30fdfaaa4403f8680eb343b538f302022-12-21T21:46:48ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-08-01810.3389/fcvm.2021.719603719603Prediction of Significant Coronary Artery Disease Through Advanced Echocardiography: Role of Non-invasive Myocardial WorkJolanda Sabatino0Jolanda Sabatino1Jolanda Sabatino2Salvatore De Rosa3Salvatore De Rosa4Isabella Leo5Antonio Strangio6Carmen Spaccarotella7Carmen Spaccarotella8Alberto Polimeni9Alberto Polimeni10Sabato Sorrentino11Sabato Sorrentino12Giovanni Di Salvo13Ciro Indolfi14Ciro Indolfi15Ciro Indolfi16Division of Cardiology, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, ItalyCardiovascular Research Center, Magna Graecia University, Catanzaro, ItalyDepartment of Women's and Children's Health, University of Padua, Padua, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, ItalyCardiovascular Research Center, Magna Graecia University, Catanzaro, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, ItalyCardiovascular Research Center, Magna Graecia University, Catanzaro, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, ItalyCardiovascular Research Center, Magna Graecia University, Catanzaro, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, ItalyCardiovascular Research Center, Magna Graecia University, Catanzaro, ItalyDepartment of Women's and Children's Health, University of Padua, Padua, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, ItalyCardiovascular Research Center, Magna Graecia University, Catanzaro, ItalyMediterranea Cardiocentro, Naples, ItalyBackground: Non-invasive prediction of critical coronary artery stenosis (CAST) in patients with coronary artery disease (CAD) is challenging. Strain parameters can often capture an impairment of regional longitudinal function; however, they are load dependent. A novel non-invasive method to estimate Myocardial Work (MW) has been recently proposed, showing a strong correlation with invasive work measurements. Our aim was to investigate the ability of non-invasive MW to predict the ischaemic risk area underlying a CAST.Methods and Results: The study population comprises 80 individuals: 50 patients with CAST and 30 controls (CTRL). Echocardiography recordings were obtained before coronary angiography to measure global longitudinal strain (GLS), Myocardial Work Index (MWI), Myocardial Constructive Work (MCW), Myocardial Wasted work (MWW), Myocardial Work Efficiency (MWE). Global MWI (p = 0.048), MWE (p < 0.001), and MCW (p = 0.048) at baseline were significantly reduced in patients with CAST compared to controls (p < 0.05). Regional MWE within the myocardial segments underlying the CAST, but not LS, was significantly reduced compared to non-target segments (p < 0.001). At ROC analysis, the diagnostic performance to predict CAST for regional MWE (AUC = 0.920, p < 0.001) was higher compared to both regional post-systolic shortening index (PSI) (AUC = 0.600, p = 0.129) and regional LS (AUC = 0.546, p = 0.469).Conclusions: Non-invasive estimation of MW work indices is able to predict a CAST before invasive angiography.https://www.frontiersin.org/articles/10.3389/fcvm.2021.719603/fullcoronary artery diseaseglobal strainmyocardial workspeckle tracking echocardiographysystolic functionatherosclerosis |
| spellingShingle | Jolanda Sabatino Jolanda Sabatino Jolanda Sabatino Salvatore De Rosa Salvatore De Rosa Isabella Leo Antonio Strangio Carmen Spaccarotella Carmen Spaccarotella Alberto Polimeni Alberto Polimeni Sabato Sorrentino Sabato Sorrentino Giovanni Di Salvo Ciro Indolfi Ciro Indolfi Ciro Indolfi Prediction of Significant Coronary Artery Disease Through Advanced Echocardiography: Role of Non-invasive Myocardial Work Frontiers in Cardiovascular Medicine coronary artery disease global strain myocardial work speckle tracking echocardiography systolic function atherosclerosis |
| title | Prediction of Significant Coronary Artery Disease Through Advanced Echocardiography: Role of Non-invasive Myocardial Work |
| title_full | Prediction of Significant Coronary Artery Disease Through Advanced Echocardiography: Role of Non-invasive Myocardial Work |
| title_fullStr | Prediction of Significant Coronary Artery Disease Through Advanced Echocardiography: Role of Non-invasive Myocardial Work |
| title_full_unstemmed | Prediction of Significant Coronary Artery Disease Through Advanced Echocardiography: Role of Non-invasive Myocardial Work |
| title_short | Prediction of Significant Coronary Artery Disease Through Advanced Echocardiography: Role of Non-invasive Myocardial Work |
| title_sort | prediction of significant coronary artery disease through advanced echocardiography role of non invasive myocardial work |
| topic | coronary artery disease global strain myocardial work speckle tracking echocardiography systolic function atherosclerosis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.719603/full |
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