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Journal ID : TMJ-17-10-2022-11424
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Title : Comparison between two-dimensional speckle tracking echocardiography and technetium sestemibi myocardial perfusion imaging in detecting coronary artery disease

Abstract :

Speckle tracking Echo is a present-day hand-held ultrasound imaging echo approach that permits a quantitative and objective assessment of local and global myocardial characteristics impartial from the angle of insonation and translational movements of the heart. It presently predicts coronary artery disease, and with the wonderful software program, software utility, this technique may be extra accurate for diagnosing and ruling out suspected coronary artery disorder (CAD). We aimed to compare 2D (two-dimensional) speckle-tracking echocardiography with a myocardial perfusion scan for the detection of suspected coronary artery stenosis. This study was carried out in National Heart Institute and Zagazig University hospital in Egypt between Jan 2021 and Jan 2022. We consecutively enrolled 120 patients underwent 2D speckle tracking echocardiography, technetium myocardial perfusion scan and coronary angiography study of suspected coronary artery stenosis patients and they were divided into two groups, group (1) is control one, and group (2) is diseased one. Two blinded operators generated a 17-segment bull's-eye map of longitudinal strain (LS), SPECT images, and coronary angiography films (reference). Comparisons between regional, global longitudinal strain and SPECT have been done. There was a statistically significant difference in global longitudinal strain (GLS), of a group (2) and proximal (basal, middle, and distal) LAD lesions (segment #17), and mean ± SD for the GLS in a group (2) turned into -14 ± 6.5, making the P-value surprisingly highly significant (P < 0.01), and a mean ± SD -10.4 ± 4 of proximal LCX lesions in segment #3, the p-value is enormously significant (P < 0.01). No statistically significant differences were found between patients with GLS and one-vascular, bi-vascular, or multi-vascular disease. In the control group (group 1), there was no statistically significant difference between patients with significant and non-significant coronary artery lesions in terms of regional longitudinal strain, regardless of the artery involved. We found that speckle-tracking echocardiography (STE) is a sensitive and less specific indicator of myocardial dysfunction that cannot distinguish between patients with 1-, 2-, or 3-vessel coronary artery disease and that it is a highly sensitive and less specific indicator of myocardial dysfunction. Speckle tacking Echocardiography (STE) is a sensitive indicator of myocardial dysfunction which includes ischemic coronary heart disease, and more useful for the detection and localization of proximal CAD lesions than the distal lesions. The global longitudinal strain is sensitive for detection of CAD and has a strong negative predictive value so it can be used as screening test and may rule out ischemia in patients provided with symptoms suggesting IHD.

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