Increased deformation of the left ventricle during exercise test measured by global longitudinal strain can rule out significant coronary artery disease in patients with suspected unstable angina pectoris

医学 冠状动脉疾病 心脏病学 内科学 胸痛 狭窄 心绞痛 心室 射血分数 压力测试(软件) 不稳定型心绞痛 心肌桥 冠状动脉造影 心肌梗塞 心力衰竭 程序设计语言 计算机科学
作者
Sigve Karlsen,Daniela Melichova,Thomas Dahlslett,Bjørnar Grenne,Benthe Sjøli,Otto A. Smiseth,Thor Edvardsen,Harald Brunvand
出处
期刊:Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques [Wiley]
卷期号:39 (2): 233-239 被引量:4
标识
DOI:10.1111/echo.15295
摘要

Noninvasive identification of significant coronary artery disease (CAD) in patients with unstable angina pectoris (UAP) is challenging. Exercise stress testing has been used for years in patients with suspected CAD but has low diagnostic accuracy. The use of Global longitudinal strain (GLS) by speckle tracking echocardiography is a highly sensitive and reproducible parameter for detection of myocardial ischemia. Our aim was to study if identification of normal or ischemic myocardium by measurement of GLS immediately after an ordinary bicycle exercise stress testing in patients with suspected UAP could identify or rule out significant CAD.Seventy-eight patients referred for coronary angiography from outpatient clinics and the emergency department with chest pain, inconclusive ECG and normal values of Troponin-T was included. All patients underwent echocardiographic examination at rest and immediately after maximum stress by exercise on a stationary bicycle. Significant CAD was defined by diameter stenosis > 90% by coronary angiography. In patients with coronary stenosis between 50-90%, fractional flow reserve (FFR) was measured and defined abnormal < .80. Analysis of echocardiographic data were performed blinded for angiographic data. Patients were discharged diagnosed with CAD (n = 34) or non-coronary chest pain (NCCP, n = 44).In patients with NCCP, GLS at rest was -21.1 ± 1.7% and -25.5 ± 2.6% at maximum stress (P < .01). In patients with CAD, GLS at rest was -16.8 ± 4.0% and remained unchanged at maximum stress (-16.6 ± 4.6%, P = .69). In patients with NCCP, LVEF was 56.1% ± 6.0 and increased to 61.8% 5.2, P < .01. In CAD patients, LVEF at rest was 54.7% ± 8.6 and increased to 58.2% ± 9.5 during stress, P = .16. In NCCP patients, Wall Motion Score index decreased .02 ± .07, P = .03 during stress and was without significant changes in patients with CAD. Area under the curve (AUC) for distinguishing CAD for was .97 (.95-1.00), .63 (.49-.76), and .71 (.59-.83) for GLS, LVEF, and WMSi, respectively.In patients with suspected UAP, increased deformation of the left ventricle measured by GLS immediately after exercise stress testing identified normal myocardium without CAD. Reduced LV contractile function by GLS without increase after exercise identified significant CAD.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
榜一大哥的负担完成签到 ,获得积分10
1秒前
Lucas应助qi0625采纳,获得10
1秒前
顾矜应助以筱采纳,获得10
2秒前
景清完成签到,获得积分10
2秒前
细心香烟完成签到 ,获得积分10
2秒前
hu完成签到 ,获得积分10
2秒前
HQ完成签到,获得积分10
2秒前
3秒前
水清木华完成签到,获得积分10
3秒前
4秒前
miao完成签到,获得积分20
4秒前
xyp_zjut应助学术乞丐采纳,获得10
4秒前
Lucas应助凉白开采纳,获得10
4秒前
体贴凌柏发布了新的文献求助10
5秒前
5秒前
5秒前
鹿子完成签到 ,获得积分10
5秒前
秋枫忆完成签到,获得积分10
7秒前
宋立发布了新的文献求助10
7秒前
孤独的AD钙完成签到,获得积分10
7秒前
8秒前
fang应助miao采纳,获得10
9秒前
星辰与月完成签到,获得积分10
9秒前
Pt-SACs发布了新的文献求助10
9秒前
安静无招完成签到 ,获得积分10
13秒前
lqphysics完成签到,获得积分10
14秒前
Jerry完成签到 ,获得积分10
14秒前
枕星发布了新的文献求助10
14秒前
全职法师刘海柱完成签到,获得积分10
16秒前
Umar完成签到,获得积分10
16秒前
accepted完成签到,获得积分10
17秒前
18秒前
Pt-SACs完成签到,获得积分10
19秒前
wgglegg完成签到 ,获得积分10
19秒前
饱满跳跳糖完成签到,获得积分10
19秒前
zhaoxiaonuan完成签到,获得积分10
19秒前
20秒前
赘婿应助2023204306324采纳,获得10
20秒前
英勇笑萍完成签到,获得积分10
21秒前
yar完成签到 ,获得积分10
22秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038368
求助须知:如何正确求助?哪些是违规求助? 3576068
关于积分的说明 11374313
捐赠科研通 3305780
什么是DOI,文献DOI怎么找? 1819322
邀请新用户注册赠送积分活动 892672
科研通“疑难数据库(出版商)”最低求助积分说明 815029