Cargando…
The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography
BACKGROUND: Two-dimensional speckle-tracking echocardiography (STE) may help detect coronary artery disease (CAD) when combined with dobutamine stress echocardiography. However, few studies have explored STE with exercise stress echocardiography (ESE). We aimed to evaluate the feasibility, reliabili...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305986/ https://www.ncbi.nlm.nih.gov/pubmed/34301240 http://dx.doi.org/10.1186/s12947-021-00259-w |
_version_ | 1783727701965668352 |
---|---|
author | d’Entremont, Marc-André Fortin, Gabriel Huynh, Thao Croteau, Étienne Farand, Paul Lemaire-Paquette, Samuel Brochu, Marie-Claude Do, Doan Hoa Lepage, Serge Mampuya, Warner Mbuila Couture, Étienne L. Nguyen, Michel Essadiqi, Btissama |
author_facet | d’Entremont, Marc-André Fortin, Gabriel Huynh, Thao Croteau, Étienne Farand, Paul Lemaire-Paquette, Samuel Brochu, Marie-Claude Do, Doan Hoa Lepage, Serge Mampuya, Warner Mbuila Couture, Étienne L. Nguyen, Michel Essadiqi, Btissama |
author_sort | d’Entremont, Marc-André |
collection | PubMed |
description | BACKGROUND: Two-dimensional speckle-tracking echocardiography (STE) may help detect coronary artery disease (CAD) when combined with dobutamine stress echocardiography. However, few studies have explored STE with exercise stress echocardiography (ESE). We aimed to evaluate the feasibility, reliability, and incremental value of STE combined with treadmill ESE compared to treadmill ESE alone to detect CAD. METHODS: We conducted a case–control study of all consecutive patients with abnormal ESE in 2018–2020 who subsequently underwent coronary angiography within a six-month interval. We 1:1 propensity score-matched these patients to those with a normal ESE. Two blinded operators generated a 17-segment bull's-eye map of longitudinal strain (LS). We utilized the mean differences between stress and baseline LS values in segments 13–17, segment 17, and segments 15–16 to create receiver operator curves for the overall examination, the left anterior descending artery (LAD), and the non-LAD territories, respectively. RESULTS: We excluded 61 STEs from 201 (30.3%) eligible ESEs; 47 (23.4%) because of suboptimal image quality and 14 (7.0%) because of excessive heart rate variability precluding the calculation of a bull's-eye map. After matching, a total of 102 patients were included (51 patients in each group). In the group with abnormal ESE patients (mean age 66.4 years, 39.2% female), 64.7% had significant CAD (> 70% stenosis) at coronary angiogram. In the group with normal ESE patients (mean age 65.1 years, 35.3% female), 3.9% were diagnosed with a new significant coronary stenosis within one year. The intra-class correlation for global LS was 0.87 at rest and 0.92 at stress, and 0.84 at rest, and 0.89 at stress for the apical segments. The diagnostic accuracy of combining ESE and STE was superior to visual assessment alone for the overall examination (area under the curve (AUC) = 0.89 vs. 0.84, p = 0.025), the non-LAD territory (AUC = 0.83 vs. 0.70, p = 0.006), but not the LAD territory (AUC = 0.79 vs. 0.73, p = 0.11). CONCLUSIONS: Two-dimensional speckle-tracking combined with treadmill ESE is relatively feasible, reliable, and may provide incremental diagnostic value for the detection and localization of significant CAD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12947-021-00259-w. |
format | Online Article Text |
id | pubmed-8305986 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-83059862021-07-28 The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography d’Entremont, Marc-André Fortin, Gabriel Huynh, Thao Croteau, Étienne Farand, Paul Lemaire-Paquette, Samuel Brochu, Marie-Claude Do, Doan Hoa Lepage, Serge Mampuya, Warner Mbuila Couture, Étienne L. Nguyen, Michel Essadiqi, Btissama Cardiovasc Ultrasound Research BACKGROUND: Two-dimensional speckle-tracking echocardiography (STE) may help detect coronary artery disease (CAD) when combined with dobutamine stress echocardiography. However, few studies have explored STE with exercise stress echocardiography (ESE). We aimed to evaluate the feasibility, reliability, and incremental value of STE combined with treadmill ESE compared to treadmill ESE alone to detect CAD. METHODS: We conducted a case–control study of all consecutive patients with abnormal ESE in 2018–2020 who subsequently underwent coronary angiography within a six-month interval. We 1:1 propensity score-matched these patients to those with a normal ESE. Two blinded operators generated a 17-segment bull's-eye map of longitudinal strain (LS). We utilized the mean differences between stress and baseline LS values in segments 13–17, segment 17, and segments 15–16 to create receiver operator curves for the overall examination, the left anterior descending artery (LAD), and the non-LAD territories, respectively. RESULTS: We excluded 61 STEs from 201 (30.3%) eligible ESEs; 47 (23.4%) because of suboptimal image quality and 14 (7.0%) because of excessive heart rate variability precluding the calculation of a bull's-eye map. After matching, a total of 102 patients were included (51 patients in each group). In the group with abnormal ESE patients (mean age 66.4 years, 39.2% female), 64.7% had significant CAD (> 70% stenosis) at coronary angiogram. In the group with normal ESE patients (mean age 65.1 years, 35.3% female), 3.9% were diagnosed with a new significant coronary stenosis within one year. The intra-class correlation for global LS was 0.87 at rest and 0.92 at stress, and 0.84 at rest, and 0.89 at stress for the apical segments. The diagnostic accuracy of combining ESE and STE was superior to visual assessment alone for the overall examination (area under the curve (AUC) = 0.89 vs. 0.84, p = 0.025), the non-LAD territory (AUC = 0.83 vs. 0.70, p = 0.006), but not the LAD territory (AUC = 0.79 vs. 0.73, p = 0.11). CONCLUSIONS: Two-dimensional speckle-tracking combined with treadmill ESE is relatively feasible, reliable, and may provide incremental diagnostic value for the detection and localization of significant CAD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12947-021-00259-w. BioMed Central 2021-07-23 /pmc/articles/PMC8305986/ /pubmed/34301240 http://dx.doi.org/10.1186/s12947-021-00259-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research d’Entremont, Marc-André Fortin, Gabriel Huynh, Thao Croteau, Étienne Farand, Paul Lemaire-Paquette, Samuel Brochu, Marie-Claude Do, Doan Hoa Lepage, Serge Mampuya, Warner Mbuila Couture, Étienne L. Nguyen, Michel Essadiqi, Btissama The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography |
title | The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography |
title_full | The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography |
title_fullStr | The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography |
title_full_unstemmed | The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography |
title_short | The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography |
title_sort | feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305986/ https://www.ncbi.nlm.nih.gov/pubmed/34301240 http://dx.doi.org/10.1186/s12947-021-00259-w |
work_keys_str_mv | AT dentremontmarcandre thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT fortingabriel thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT huynhthao thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT croteauetienne thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT farandpaul thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT lemairepaquettesamuel thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT brochumarieclaude thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT dodoanhoa thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT lepageserge thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT mampuyawarnermbuila thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT coutureetiennel thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT nguyenmichel thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT essadiqibtissama thefeasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT dentremontmarcandre feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT fortingabriel feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT huynhthao feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT croteauetienne feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT farandpaul feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT lemairepaquettesamuel feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT brochumarieclaude feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT dodoanhoa feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT lepageserge feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT mampuyawarnermbuila feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT coutureetiennel feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT nguyenmichel feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography AT essadiqibtissama feasibilityreliabilityandincrementalvalueoftwodimensionalspeckletrackingforthedetectionofsignificantcoronarystenosisaftertreadmillstressechocardiography |