Prognostic value of two-dimensional speckle-tracking echocardiography in patients with suspected ischemic heart disease

Authors

  • Ángel Y. Rodríguez Navarro
  • Aylen Pérez Barreda
  • Ronald Aroche Aportela
  • Katia Ravelo Llanes
  • Idalys M. Román Fernández
  • Joanna de Zayas Galguera

Abstract

Introduction: Two-dimensional speckle-tracking echocardiography has emerged as a novel method for the quantitative evaluation of myocardial function and it has been correlated with the presence of coronary artery disease.

Objectives: To determine the prognostic value of myocardial strain by two-dimensional speckle-tracking echocardiography in the evolution of patients with suspected ischemic heart disease.

Method: An analytical prospective longitudinal study was carried out with 51 patients, who underwent global longitudinal strain assessment by two-dimensional speckle-tracking echocardiography, and coronary angiography at CIMEQ between 2016 and 2018. Major cardiac adverse events (myocardial infarction, cardiac and non-cardiac cause of death, cerebrovascular disease, and need for new revascularization) were followed.

Results: The 70.6% of patients were male, the 81.4% were older than 50 years old, and the 81.4% were smokers. The 65.0% of patients had significant coronary artery disease and the 55.0% underwent myocardial revascularization. There were four deaths (7.8%) and one non-fatal myocardial infarction (2.0%). Patients with global longitudinal strain ≤ -15% (in absolute or modular values) had a higher frequency of major adverse cardiovascular events (p=0.02).

Conclusions: Global longitudinal strain by two-dimensional speckle-tracking echocardiography could not predict the presence of coronary artery disease, but it did predict major adverse cardiovascular events in patients with significant coronary artery disease.

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References

1. Mada RO, Duchenne J, Voigt JU. Tissue Doppler, strain and strain rate in ischemic heart disease "how I do it". Cardiovasc Ultrasound [Internet]. 2014 [citado 23 May 2020];12:38. Disponible en: https://doi.org/10.1186/1476-7120-12-38

2. Kossaify A, Bassil E, Kossaify M. Stress Echocardiography: Concept and Criteria, Structure and Steps, Obstacles and Outcomes, Focused Update and Review. Cardiol Res. 2020;11(2):89-96. [DOI] https://doi.org/10.14740/cr851

3. Luis SA, Chan J, Pellikka PA. Echocardiographic Assessment of Left Ventricular Systolic Function: An Overview of Contemporary Techniques, Including Speckle-Tracking Echocardiography. Mayo Clin Proc. 2019;94(1):125-38. [DOI] https://doi.org/10.1016/j.mayocp.2018.07.017

4. Centro Nacional de Información de Ciencias Médicas. Cardiopatía isquémica. Estadísticas Mundiales. Factográfico Salud [Internet]. 2019 [citado 23 May 2020];5(2). Disponible en: http://files.sld.cu/bmn/files/2019/02/factografico-de-salud-febrero-2019.pdf

5. Ministerio de Salud Pública. Anuario Estadístico de Salud 2018. La Habana: Dirección de Registros Médicos y Estadísticas de Salud; 2019.

6. Rivas Estany E, Barrera Sarduy JD, Henry Vera G. Prueba de esfuerzo bajo control electrocardiográfico. Revisión de guías internacionales y normas cubanas. Rev Cuban Cardiol [Internet]. 2020 [citado 20 May 2020];26(2). Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/925/pdf

7. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. Guía ESC 2019 sobre el diagnóstico y tratamiento de los síndromes coronarios crónicos. Rev Esp Cardiol. 2020;73(6):495.e1-e61. [DOI] https://doi.org/10.1016/j.recesp.2019.10.032

8. Radwan H, Hussein E. Value of global longitudinal strain by two dimensional speckle tracking echocardiography in predicting coronary artery disease severity. Egypt Heart J. 2017;69(2):95-101. [DOI] https://doi.org/10.1016/j.ehj.2016.08.001

9. Moustafa S, Elrabat K, Swailem F, Galal A. The correlation between speckle tracking echocardiography and coronary artery disease in patients with suspected stable angina pectoris. Indian Heart J. 2018;70(3):379-86. [DOI] https://doi.org/10.1016/j.ihj.2017.09.220

10. Hubbard RT, Arciniegas Calle MC, Barros-Gomes S, Kukuzke JA, Pellikka PA, Gulati R, et al. 2-Dimensional Speckle Tracking Echocardiography predicts severe coronary artery disease in women with normal left ventricular function: a case-control study. BMC Cardiovasc Disord [Internet]. 2017 [citado 20 May 2020];17(1):231. Disponible en: https://doi.org/10.1186/s12872-017-0656-5

11. Amundsen BH, Helle-Valle T, Edvardsen T, Torp H, Crosby J, Lyseggen E, et al. Noninvasive myocardial strain measurement by speckle tracking echocardiography: validation against sonomicrometry and tagged magnetic resonance imaging. J Am Coll Cardiol. 2006;47(4):789-93. [DOI] https://doi.org/10.1016/j.jacc.2005.10.040

12. Scharrenbroich J, Hamada S, Keszei A, Schröder J, Napp A, Almalla M, et al. Use of two-dimensional speckle tracking echocardiography to predict cardiac events: Comparison of patients with acute myocardial infarction and chronic coronary artery disease. Clin Cardiol. 2018;41(1):111-8. [DOI] https://doi.org/10.1002/clc.22860

13. Hu B, Zhou Q, Yao X, Tan T, Lei J, Cao Q, et al. Layer-specific strain for long-term outcome prediction after first-onset myocardial infarction. Ultrasound Med Biol. 2020;46(6):1435-41. [DOI] https://doi.org/10.1016/j.ultrasmedbio.2020.02.013

14. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. [DOI] https://doi.org/10.1016/j.echo.2014.10.003

15. Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, et al. Clinical end points in coronary stent trials: A case for standardized definitions. Circulation. 2007;115(17):2344-51. [DOI] https://doi.org/10.1161/circulationaha.106.685313

16. Hernández Navas M, Aroche Aportela R, Aldama Pérez L, Obregón Santos Á, Gil Torres I, Leal Hernández E. Importancia clínica del sangrado en pacientes con intervencionismo coronario percutáneo por vía radial en el CIMEQ. CorSalud [Internet]. 2015 [citado 25 May 2020];7(3),175-80. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/55/113

17. Armas Rojas NA, Dueñas Herrera A, de la Noval García R, Ortega Torres Y, Acosta González M, Morales Salinas A. Cardiopatía Isquémica en Cuba. Una puesta al día. Rev Cuban Cardiol [Internet]. 2015 [citado 25 May 2020];21(3). Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/597/pdf_15

18. Nafeh AM, Hernández NR, Carballo HN, Villar IA, Guevara GL, Chaos GN, et al. Resultados de la revascularización coronaria en el Cardiocentro del Hospital «Hermanos Ameijeiras», en un período de 20 años. Rev Cuba Cir. 2011;50(1):54-72.

19. Santos Pérez A, Pérez López H, Valero Hernández A, Lage López L, Borges Moreno YR. Factores preoperatorios relacionados con las complicaciones cardiovasculares de la cirugía de revascularización coronaria. Gac Méd Espirit [Internet]. 2010 [citado 26 May 2020];12(3). Disponible en: http://revgmespirituana.sld.cu/index.php/gme/article/view/1549/1700

20. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):1376-414. [DOI] https://doi.org/10.1016/j.jacc.2019.03.009

21. Aldama Pérez LI, Naranjo Domínguez A, Hernández Navas M, García Hernández RA, Aroche Aportela R, Cuba Rodríguez AL. Intervencionismo percutáneo en la enfermedad coronaria de tres vasos. Seguimiento de dos años. Rev Cuban Cardiol [Internet]. 2019 [citado 26 May 2020];25(3). Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/887/pdf

22. Alfonso Alfonso Y, Roque Pérez L, de la Cruz Pérez D, Pérez Fierro M, Batista Mestre I, Díaz Águila HR. Caracterización de los factores de riesgo en pacientes con cardiopatía isquémica Hospital “Mártires del 9 de Abril”, período 2016-2017. Rev Med Electrón [Internet]. 2019 [citado 28 May 2020];41(4). Disponible en: http://www.revmedicaelectronica.sld.cu/index.php/rme/article/view/2841/pdf_665

23. Rodríguez Navarro AY, Naranjo Domínguez AA, Aroche Aportela R. Factores de riesgo en pacientes con síndrome coronario agudo remitidos para coronariografía. CorSalud [Internet]. 2013 [citado 28 May 2020];5(3):280-4. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/527/943

24. De Servi S, Olivari Z, Crimi G, Marino M, Alberti LP, Tagliabue E, et al. Percutaneous coronary interventions for stable ischemic heart disease in Italy. J Cardiovasc Med (Hagerstown). 2019;20(11):762-7. [DOI] https://doi.org/10.2459/jcm.0000000000000835

25. Madhavan S, Narayanapillai J, Paikada JS, Jayaprakash K, Jayaprakash V. Two-dimensional speckle tracking echocardiography as a predictor of significant coronary artery stenosis in female patients with effort angina who are treadmill test positive: An angiographic correlation. J Clin Prev Cardiol. 2019;8(3):126-30. [DOI] https://doi.org/10.4103/JCPC.JCPC_6_19

26. Hagemann CA, Hoffmann S, Hagemann RA, Fritz-Hansen T, Olsen FJ, Jørgensen PG, et al. Usefulness of layer-specific strain in diagnosis of coronary artery disease in patients with stable angina pectoris. Int J Cardiovasc Imaging. 2019;35(11):1989-99. [DOI] https://doi.org/10.1007/s10554-019-01652-3

27. Biering-Sørensen T, Hoffmann S, Mogelvang R, Zeeberg Iversen A, Galatius S, Fritz-Hansen T, et al. Myocardial strain analysis by 2-dimensional speckle tracking echocardiography improves diagnostics of coronary artery stenosis in stable angina pectoris. Circ Cardiovasc Imaging. 2014;7(1):58-65. [DOI] https://doi.org/10.1161/circimaging.113.000989

28. Choi JO, Cho SW, Song YB, Cho SJ, Song BG, Lee SC, et al. Longitudinal 2D strain at rest predicts the presence of left main and three vessel coronary artery disease in patients without regional wall motion abnormality. Eur J Echocardiogr. 2009;10(5):695-701. [DOI] https://doi.org/10.1093/ejechocard/jep041

29. Norum IB, Ruddox V, Edvardsen T, Otterstad JE. Diagnostic accuracy of left ventricular longitudinal function by speckle tracking echocardiography to predict significant coronary artery stenosis. A systematic review. BMC Med Imaging [Internet]. 2015 [citado 31 May 2020];15:25. Disponible en: https://doi.org/10.1186/s12880-015-0067-y

30. Bakhoum SWG, Taha HS, Abdelmonem YY, Fahim MAS. Value of resting myocardial deformation assessment by two dimensional speckle tracking echocardiography to predict the presence, extent and localization of coronary artery affection in patients with suspected stable coronary artery disease. The Egypt Heart J. 2016;68(3):171-9. [DOI] http://dx.doi.org/10.1016/j.ehj.2016.02.001

31. Sarvari SI, Haugaa KH, Zahid W, Bendz B, Aakhus S, Aaberge L, et al. Layer-specific quantification of myocardial deformation by strain echocardiography may reveal significant CAD in patients with non-ST-segment elevation acute coronary syndrome. JACC Cardiovasc Imaging. 2013;6(5):535-44. [DOI] https://doi.org/10.1016/j.jcmg.2013.01.009

32. Zhang L, Wu WC, Ma H, Wang H. Usefulness of layer-specific strain for identifying complex CAD and predicting the severity of coronary lesions in patients with non-ST-segment elevation acute coronary syndrome: Compared with Syntax score. Int J Cardiol. 2016;223:1045-52. [DOI] https://doi.org/10.1016/j.ijcard.2016.08.277

33. Lacalzada J, de la Rosa A, Izquierdo MM, Jiménez JJ, Iribarren JL, García-González MJ, et al. Left ventricular global longitudinal systolic strain predicts adverse remodeling and subsequent cardiac events in patients with acute myocardial infarction treated with primary percutaneous coronary intervention. Int J Cardiovasc Imaging. 2015;31(3):575-84. [DOI] https://doi.org/10.1007/s10554-015-0593-2

34. Nahum J, Bensaid A, Dussault C, Macron L, Clémence D, Bouhemad B, et al. Impact of longitudinal myocardial deformation on the prognosis of chronic heart failure patients. Circ Cardiovasc Imaging. 2010;3(3):249-56. [DOI] https://doi.org/10.1161/circimaging.109.910893

35. Zhang KW, French B, May Khan A, Plappert T, Fang JC, Sweitzer NK, et al. Strain improves risk prediction beyond ejection fraction in chronic systolic heart failure. J Am Heart Assoc [Internet]. 2014 [citado 31 May 2020];3(1):e000550. Disponible en: https://doi.org/10.1161/jaha.113.000550

36. Cho GY, Marwick TH, Kim HS, Kim MK, Hong KS, Oh DJ. Global 2-dimensional strain as a new prognosticator in patients with heart failure. J Am Coll Cardiol. 2009;54(7):618-24. [DOI] https://doi.org/10.1016/j.jacc.2009.04.061

37. Hung CL, Verma A, Uno H, Shin SH, Bourgoun M, Hassanein AH, et al. Longitudinal and circumferential strain rate, left ventricular remodeling, and prognosis after myocardial infarction. J Am Coll Cardiol. 2010;56(22):1812-22. [DOI] https://doi.org/10.1016/j.jacc.2010.06.044

38. Ersbøll M, Valeur N, Mogensen UM, Andersen MJ, Møller JE, Velazquez EJ, et al. Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction. J Am Coll Cardiol. 2013;61(23):2365-73. [DOI] https://doi.org/10.1016/j.jacc.2013.02.061

39. Bertini M, Ng AC, Antoni ML, Nucifora G, Ewe SH, Auger D, et al. Global longitudinal strain predicts long-term survival in patients with chronic ischemic cardiomyopathy. Circ Cardiovasc Imaging. 2012;5(3):383-91. [DOI] https://doi.org/10.1161/circimaging.111.970434

40. Potter E, Marwick TH. Assessment of left ventricular function by echocardiography: The case for routinely adding global longitudinal strain to ejection fraction. JACC Cardiovasc Imaging. 2018;11(2 Pt 1):260-74. [DOI] https://doi.org/10.1016/j.jcmg.2017.11.017

41. Thavendiranathan P, Poulin F, Lim KD, Plana JC, Woo A, Marwick TH. Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy: A systematic review. J Am Coll Cardiol. 2014;63(25 Pt A):2751-68. [DOI] https://doi.org/10.1016/j.jacc.2014.01.073

42. Yingchoncharoen T, Gibby C, Rodriguez LL, Grimm RA, Marwick TH. Association of myocardial deformation with outcome in asymptomatic aortic stenosis with normal ejection fraction. Circ Cardiovasc Imaging. 2012;5(6):719-25. [DOI] https://doi.org/10.1161/circimaging.112.977348

43. Liu H, Pozios I, Haileselassie B, Nowbar A, Sorensen LL, Phillip S, et al. Role of global longitudinal strain in predicting outcomes in hypertrophic cardiomyopathy. Am J Cardiol. 2017;120(4):670-5. [DOI] https://doi.org/10.1016/j.amjcard.2017.05.039

44. Kuznetsova T, Herbots L, Richart T, D'hooge J, Thijs L, Fagard RH, et al. Left ventricular strain and strain rate in a general population. Eur Heart J. 2008;29(16):2014-23. [DOI] https://doi.org/10.1093/eurheartj/ehn280

45. Jensen MT, Sogaard P, Andersen HU, Bech J, Fritz Hansen T, Biering-Sørensen T, et al. Global longitudinal strain is not impaired in type 1 diabetes patients without albuminuria: the Thousand & 1 study. JACC Cardiovasc Imaging. 2015;8(4):400-10. [DOI] https://doi.org/10.1016/j.jcmg.2014.12.020

46. Narayanan A, Aurigemma GP, Chinali M, Hill JC, Meyer TE, Tighe DA. Cardiac mechanics in mild hypertensive heart disease: a speckle-strain imaging study. Circ Cardiovasc Imaging. 2009;2(5):382-90. [DOI] https://doi.org/10.1161/circimaging.108.811620

47. Wong CY, O'Moore-Sullivan T, Leano R, Byrne N, Beller E, Marwick TH. Alterations of left ventricular myocardial characteristics associated with obesity. Circulation. 2004;110(19):3081-7. [DOI] https://doi.org/10.1161/01.cir.0000147184.13872.0F

48. Lauridsen TK, Alhede C, Crowley AL, Kisslo J, Sørensen LL, Hansen TF, et al. Two-dimensional global longitudinal strain is superior to left ventricular ejection fraction in prediction of outcome in patients with left-sided infective endocarditis. Int J Cardiol. 2018;260:118-23. [DOI] https://doi.org/10.1016/j.ijcard.2018.01.031

49. Khidir MJH, Abou R, Yilmaz D, Ajmone Marsan N, Delgado V, Bax JJ. Prognostic value of global longitudinal strain in heart failure patients treated with cardiac resynchronization therapy. Heart Rhythm. 2018;15(10):1533-9. [DOI] https://doi.org/10.1016/j.hrthm.2018.03.034

50. Yadlapati A, Maher TR, Thomas JD, Gajjar M, Ogunyankin KO, Puthumana JJ. Global longitudinal strain from resting echocardiogram is associated with long-term adverse cardiac outcomes in patients with suspected coronary artery disease. Perfusion. 2017;32(7):529-37. [DOI] https://doi.org/10.1177/0267659117701563

51. Felekos I, Aggeli C, Gialafos E, Kouranos V, Rapti A, Sfikakis P, et al. Global longitudinal strain and long-term outcomes in asymptomatic extracardiac sarcoid patients with no apparent cardiovascular disease. Echocardiography. 2018;35(6):804-8. [DOI] https://doi.org/10.1111/echo.13846

52. Sikora-Frac M, Zaborska B, Maciejewski P, Budaj A, Bednarz B. Improvement of left ventricular function after percutaneous coronary intervention in patients with stable coronary artery disease and preserved ejection fraction: Impact of diabetes mellitus. Cardiol J. 2019. [DOI] https://doi.org/10.5603/cj.a2019.0066

53. Jahn L, Kramann R, Marx N, Floege J, Becker M, Schlieper G. Speckle tracking echocardiography and all-cause and cardiovascular mortality risk in chronic kidney disease patients. Kidney Blood Press Res. 2019;44(4):690-703. [DOI] https://doi.org/10.1159/000501225

54. Jung IH, Park JH, Lee JA, Kim GS, Lee HY, Byun YS, et al. Left ventricular global longitudinal strain as a predictor for left ventricular reverse remodeling in dilated cardiomyopathy. J Cardiovasc Imaging. 2020;28(2):137-49. [DOI] https://doi.org/10.4250/jcvi.2019.0111

55. Kaufmann D, Szwoch M, Kwiatkowska J, Raczak G, Daniłowicz-Szymanowicz L. Global longitudinal strain can predict heart failure exacerbation in stable outpatients with ischemic left ventricular systolic dysfunction. PLoS One [Internet]. 2019 [citado 5 Jun 2020];14(12):e0225829. Disponible en: https://doi.org/10.1371/journal.pone.0225829

56. Al Saikhan L, Park C, Hardy R, Hughes A. Prognostic implications of left ventricular strain by speckle-tracking echocardiography in the general population: a meta-analysis. Vasc Health Risk Manag. 2019;15:229-51. [DOI] https://doi.org/10.2147/vhrm.s206747

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Published

2021-01-16

How to Cite

1.
Rodríguez Navarro Ángel Y, Pérez Barreda A, Aroche Aportela R, Ravelo Llanes K, Román Fernández IM, de Zayas Galguera J. Prognostic value of two-dimensional speckle-tracking echocardiography in patients with suspected ischemic heart disease. CorSalud [Internet]. 2021 Jan. 16 [cited 2025 Jul. 13];13(1):19-31. Available from: https://revcorsalud.sld.cu/index.php/cors/article/view/801

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Vol. 13 No. 1 (2021)

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ORIGINAL ARTICLES

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