The correlation between speckle-tracking echocardiography and coronary angiography in suspected coronary artery disease with normal left ventricular function

Introduction: Our study objects to determine the diagnostic accuracy of two-dimensional speckle tracking echocardiography (2DSTE) in predicting presence and severity of coronary artery disease (CAD). Methods: Patients with stable angina pectoris with normal left ventricular function ( 50%) undergoing coronary angiography were enrolled and subjected to speckle tracking echocardiography. Global longitudinal peak systolic strain was measured and correlated to the results of coronary angiography for each patient. Results: Number of male (P = 0.001), diabetes (P = 0.01) and smoking (P = 0.01) patients were significantly higher in the CAD group compared to non-CAD patients. Global longitudinal peak systolic strain (GLPSS) was significantly (P = 0.0001) lower in CAD patients in comparison to non- CAD patients. GLPSS showed significantly lower in patients with Syntax score (SS) ≥ 22 in comparison to SS 22. Cut-off value -19 for GLPSS could be used to predict the presence of significant CAD with 80.6% sensitivity and 76.5% specificity (area under curve (AUC) -0.83, P = 0.0001). The mean GLPSS value decreased as the number of diseased coronary vessels increased (P = 0.0001). The optimal cut-off value of -16 GLPSS with a sensitivity of 76.7% and specificity of 83.3% [AUC 0.84, P 0.0001] was found significant to predict CAD severity. Multivariate regression of GLPSS and another risk factor for predicting significant CAD, GLPSS showed OR = 1.55 (CI-1.36-1.76) P = 0.0001 for predicting the presence of CAD. Conclusion: 2DSTE can be used as a non-invasive screening test in predicting presence, extent and severity of significant CAD patients with suspected stable angina pectoris.