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

Abstract

Aim: This study aims to determine the diagnostic accuracy of two-dimensional speckle tracking echocardiography (2DSTE) in predicting the angiographic severity of coronary artery disease (CAD) in female patients with effort angina who are treadmill test (TMT) positive and for risk stratification, to decide on the need for invasive management. Materials and Methods: A total of 1000 female patients with effort angina who are TMT positive and are recommended for coronary angiogram based on standard treatment guidelines are subjected to 2DSTE and global longitudinal strain (GLS) score is obtained. Angiographic correlation was sought between lesion severity and GLS score. Results: The average age of patients included in the study is 55 years. Average Duke Score is −2. Average GLS score −15. 56% of patients had a significant coronary lesion of >70% in at least one of the coronary arteries. The optimum cutoff GLS score to predict significant coronary lesion is −17.5. Conclusion: GLS by 2DSTE correlates well with angiographic severity of CAD and can predict significant coronary lesion with a sensitivity of 94% and specificity of 76% in female patients with effort angina. Thus, GLS by 2DSTE can be used as a noninvasive screening test in predicting significant coronary artery stenosis and can complement TMT in risk stratification and in selecting patients for coronary angiogram.

Keywords

• False-positive treadmill test
• global longitudinal strain
• speckle tracking echocardiography
• stable coronary artery disease