The Behavior of Regional Longitudinal Strain Depends on Coronary Flow Reserve in a Simultaneous Analysis during Dipyridamole Stress Echocardiography

Rosina Arbucci, Diego M. Lowenstein Haber, Ariel K. Saad, Graciela Rousse, Miguel Amor, Gustavo Zambrana, Daniela Sevilla, Sabrina Sciolini, Pablo M. Merlo, Jorge A. Lowenstein


Background: The behavior of regional and global longitudinal strain in relation to the value of the coronary reserve is poorlystudied.Objectives: Compare the behavior of the Apical and global longitudinal Strain with the value of the coronary reserve of theanterior descending artery and as a secondary aim compare these responses with the visual analysis of parietal motility duringEcho Stress with Dipyridamole.Materials and methods: Retrospective study of 179 patients (age 68.7±7.8), 90 patients (50.3%) were men. At the peak of thedipyridamole effect, the coronary reserve was measured, simultaneously with the Longitudinal Strain and the visual analisis ofcontractility. Two groups were divided: Group 1: Coronary reserve ≥2 and Group 2: <2. Apical Strain was defined as the averageof 4 apical segments and global as the average of the 17 segments. It was considered normal any increased of deformationResults: 113 patients (63.12%) were included in Group 1 and 66 (36.87%) in Group 2. Strain Apical: 96.77% of Group 1 increasedtheir strain values with the stress, while in group 2, 95.31% presented a worsening strain values (p<0.0001). Global Strain:82.8% of Group 1 had an increase in their values, while in Group 2, 78.8% showed worsening (p<0.01). Post Dipyridamoleparietal Motility Analysis: 96.46% of Group 1 had preserved parietal motility and only 54.5% of Group 2 (4 patients hadincreased apical Strain in this group).Conclusions: There was a close correlation between the coronary reserve of the anterior descending artery and the contractilereserve evaluated by regional apical longitudinal strain of the 4 apical segments, which was superior to the use of globalstrain. The Apical Strain showed a better correlation with ADA coronary reserve than with the visual analysis of contractility.


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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