Usefulness of Two-Dimensional Speckle Strain for Evaluation of Left Ventricular Diastolic Deformation in Patients With Coronary Artery Disease

We investigated the influence of ≥70% luminal coronary artery stenosis on regional diastolic deformation at rest using 2-dimensional strain echocardiography. We prospectively imaged patients during/within 24 hours of coronary angiography. Longitudinal systolic (SRs), early (SRe), and late diastolic strain rates, systolic, early, and late diastolic strain and times to isovolumic relaxation and peak SRe were measured in the 3 major vascular territories. Regions subtended by ≥70% coronary stenosis were labeled ischemic. Ischemic regions were compared with the same region in patients without significant coronary stenosis. Of 61 enrolled patients (38 men), 39 had ≥70% coronary stenosis (1 vessel in 14, 2 vessels in 15, 3 vessels in 10), and 15 had normal coronary arteries. There were no significant differences between the normal and ischemic groups with regard to age (59 ± 13 vs 64 ± 10 years, p = 0.20), clinical variables (dyslipidemia, smoking, diabetes), systolic (130 ± 26 vs 139 ± 31 mm Hg, p = 0.38) or diastolic (72 ± 13 vs 72 ± 11 mm Hg, p = 0.81) blood pressure and ejection fraction (58 ± 12% vs 56 ± 11%, p = 0.66). SRs and SRe were significantly decreased in ischemic compared with normal regions in all vascular distributions. SRs and SRe together (values below cutoff) or SRe alone were the most specific (93%) and SRe or SRs below cutoff the most sensitive (93%) parameters for detecting ischemic regions. In conclusion, analysis of regional deformation by 2-dimensional strain echocardiography enables detection of significantly diseased coronary arteries at rest. Altered diastolic deformation at rest identifies regions subtended by ≥70% coronary stenosis with high specificity.