Early diastolic strain rate by two-dimensional speckle tracking echocardiography is a predictor of coronary artery disease and cardiovascular events in stable angina pectoris
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Early diastolic strain rate by two-dimensional speckle tracking echocardiography is a predictor of coronary artery disease and cardiovascular events in stable angina pectoris. / Hagemann, Rikke A.; Hoffmann, Søren; Brainin, Philip; Hagemann, Christoffer A.; Fritz-Hansen, Thomas; Olsen, Flemming J.; Møgelvang, Rasmus; Biering-Sørensen, Tor.
In: International Journal of Cardiovascular Imaging, Vol. 36, 2020, p. 1249-1260.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Early diastolic strain rate by two-dimensional speckle tracking echocardiography is a predictor of coronary artery disease and cardiovascular events in stable angina pectoris
AU - Hagemann, Rikke A.
AU - Hoffmann, Søren
AU - Brainin, Philip
AU - Hagemann, Christoffer A.
AU - Fritz-Hansen, Thomas
AU - Olsen, Flemming J.
AU - Møgelvang, Rasmus
AU - Biering-Sørensen, Tor
PY - 2020
Y1 - 2020
N2 - This study aimed to clarify the diagnostic and prognostic potential of strain rate in patients with suspected stable angina pectoris (SAP). Strain rate by 2-dimensional speckle tracking echocardiography (2DSTE) has been suggested to be able to diagnose coronary artery disease (CAD) and predict cardiovascular events in various patient groups. Prospectively enrolled patients (n = 296) with suspected SAP, no previous cardiac disease, and normal left ventricular ejection fraction were examined by 2DSTE, exercise ECG, and coronary angiography. Obstructive CAD was defined as stenosis ≥ 70% in ≥ 1 coronary artery on coronary angiography (n = 107). Major adverse cardiac events (MACE) included myocardial infarction, heart failure, atrial fibrillation, and stroke. In multivariable analysis adjusted for baseline data, conventional echocardiography, and Duke score, early diastolic strain rate (SRe) was independently associated with significant CAD with a 1.35 increased risk of having CAD per 0.1 decrease in SRe (OR = 1.35, 95% CI 1.03–1.76, P = 0.027). Peak velocity of early diastolic filling (E)/SRe was not associated with significant CAD (OR = 1.14, 95% CI 0.81–1.62, P = 0.445). MACE occurred in 34 patients (12%) during follow-up (median 3.5 years) and both SRe (HR 1.26, 95% CI (1.07–1.49), P = 0.006) and E/SRe (HR 1.24, 95% CI (1.04–1.47), P = 0.017) were independent predictors after multivariable adjustment. In patients with suspected SAP, SRe by 2DSTE was independently associated with presence of CAD. In addition, SRe and E/SRe provided independent and incremental prognostic value for predicting future MACE.
AB - This study aimed to clarify the diagnostic and prognostic potential of strain rate in patients with suspected stable angina pectoris (SAP). Strain rate by 2-dimensional speckle tracking echocardiography (2DSTE) has been suggested to be able to diagnose coronary artery disease (CAD) and predict cardiovascular events in various patient groups. Prospectively enrolled patients (n = 296) with suspected SAP, no previous cardiac disease, and normal left ventricular ejection fraction were examined by 2DSTE, exercise ECG, and coronary angiography. Obstructive CAD was defined as stenosis ≥ 70% in ≥ 1 coronary artery on coronary angiography (n = 107). Major adverse cardiac events (MACE) included myocardial infarction, heart failure, atrial fibrillation, and stroke. In multivariable analysis adjusted for baseline data, conventional echocardiography, and Duke score, early diastolic strain rate (SRe) was independently associated with significant CAD with a 1.35 increased risk of having CAD per 0.1 decrease in SRe (OR = 1.35, 95% CI 1.03–1.76, P = 0.027). Peak velocity of early diastolic filling (E)/SRe was not associated with significant CAD (OR = 1.14, 95% CI 0.81–1.62, P = 0.445). MACE occurred in 34 patients (12%) during follow-up (median 3.5 years) and both SRe (HR 1.26, 95% CI (1.07–1.49), P = 0.006) and E/SRe (HR 1.24, 95% CI (1.04–1.47), P = 0.017) were independent predictors after multivariable adjustment. In patients with suspected SAP, SRe by 2DSTE was independently associated with presence of CAD. In addition, SRe and E/SRe provided independent and incremental prognostic value for predicting future MACE.
KW - Coronary artery disease
KW - Echocardiography
KW - Speckle tracking
KW - Strain rate imaging
U2 - 10.1007/s10554-020-01822-8
DO - 10.1007/s10554-020-01822-8
M3 - Journal article
C2 - 32405734
AN - SCOPUS:85084700351
VL - 36
SP - 1249
EP - 1260
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
SN - 1569-5794
ER -
ID: 244652309