Role of Left Ventricular Speckle Tracking Imaging in Detection of Coronary Artery Disease in Non-Diabetic Patients

This study aimed to determine the role of global longitudinal strain (GLS) in early diagnosis and detection of severity of coronary artery disease (CAD) in non-diabetic patients with preserved left ventricular ejection fraction (EF) without regional wall motion abnormalities presented with chronic coronary syndrome, and to identify the role of territorial longitudinal strain (TLS) in detection of the affected coronary artery. We enrolled 60 non-diabetic patients with suspected CAD who underwent resting echocardiography and speckle tracking imaging and subsequently coronary angiography then results were correlated together. Patients with family history of CAD (68.3%), hypertension (68.3%), smokers (43.3%), and dyslipidemia (81.6%). All participants had normal left ventricular systolic function with mean EF of 64.02±6.15% and no regional wall motion abnormalities at rest. Patients were classified angiographically according to the number of the diseased vessels into: 3 vessels disease (43.3%), 1-2 vessels disease (35%), and normal coronary angiography (21.7%) with GLS mean values of -13.69±1.94%, -15.4±1.74%, and -18.80±2.14%, respectively. There was a negative significant correlation between GLS values and the number of diseased vessels (P=0.001). The values of TLS were significantly lower in myocardial regions supplied by stenotic arteries than those supplied by non-stenotic arteries. Mean TLS values for stenotic left anterior descending, left circumflex, and right coronary arteries were -15.51±3.19, -13.06±2.90, -13.27±2.60 with P=0.011, 0.001, and 0.001, respectively. Speckle tracking derived GLS is an effective non-invasive method in predicting presence and severity of CAD and in locating the affected vessels based on the distribution of segments affected in TLS.