Non-Invasive Assessment of Coronary Artery Stenosis with Estimation of Myocardial Wall Stress

Abstract

Background: More diagnostic techniques require a better understanding of the forces and stresses developed in the wall of the left ventricle. The aim of this study was to differentiate significant coronary artery disease (CAD) patients using a non-invasive quantification of myocardial wall stress in the diastole phase. Methods: Sixty male subjects with sinus rhythm (30 patients with significant and 30 with moderate left anterior descending coronary artery stenosis in the proximal portion) as well as 35 healthy subjects as the control group were recruited into the present study. By two-dimensional, pulsed wave, and tissue Doppler echocardiography, the average end-diastolic wall stress was calculated at the left ventricle anterior and interventricular septum wall segments using regional wall thickness, meridional and circumferential radii, and non-invasive left ventricular end-diastolic pressure. Results: A comparison of the calculated end-diastolic myocardial wall stress between the patients with significant and moderate coronary stenosis on the one hand and the healthy subjects on the other showed statistically significant differences in the anterior and septum wall segments (p value < 0.05). The patients with significant left anterior descending coronary artery stenosis had higher end-diastolic myocardial wall stress than did those with moderate stenosis and the healthy group in all the anterior and septum wall segments. Conclusion: It is concluded that non-invasive end-diastolic myocardial wall stress in coronary artery disease patients is an important index in evaluating myocardial performance.

Keywords

• Coronary artery disease
• Echocardiography
• Diagnosis