Longitudinal Strain at Rest does not Predict Stress Echo Results

Natalio Gastaldello, Pablo Merlo, Miguel Amor, Diego Alasia, Marcela Galello, María Rousse, Norberto Caso, Cristian Caniggia, Víctor Darú, Jorge Lowenstein


Background: Stress echo shows ischemia as a transient regional motility disorder. The subjective visual analysis which is dependenton the operator’s experience has prompted the search for a semiautomatic method to mitigate this limitation and improve thereliability and reproducibility of the test. This has generated a growing interest in the introduction of two-dimensional longitudinalstrain before, during and after stress echo. If useful, its assessment during the different stress stages would attenuate other limitations,such as the inability to achieve submaximal heart rate, difficult visualization of more subtle disorders and delay in imageacquisition, which increases false negative results.Objectives: The aim of this study was to assess whether longitudinal strain analysis at rest is able to predict the outcome of stressecho when there is no visual evidence of contractile disorders, and whether baseline longitudinal strain is different in patients withsignificant coronary artery disease compared with patients not presenting this disease (in their previous evaluation before the test).Methods: The study compared longitudinal strain results at rest in 62 patients with positive stress echo consecutively recruitedduring a 12-month period, half of whom underwent coronary angiography(Group A) and the other half did not undertake this study(Group B) versus a control group (Group C) with negative test and without coronary angiography.Results: Longitudinal strain showed no significant difference between groups A and B (-21.8%±2.4% vs. -21.5% ±2.5%) and neitherbetween patients with positive test (Group A+B) versus Group C (-21.67 % ±2.4% vs. -21.9 %±2.8%).Conclusions: Two-dimensional longitudinal strain did not predict stress echo results or the presence of significant coronary arterydisease in the group of patients undergoing invasive coronary angiography.

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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar