The Correlation Between Global Longitudinal Strain by Speckle Tracking Echocardiography and Coronary Angiogram Finding in Patients with Suspected Chronic Stable Angina Pectoris

The objective of this study was to evaluate and forecast the significance of Global Longitudinal Strain (GLS) measured at rest and its correlation with the presence and severity of coronary artery disease (CAD) in individuals with suspected stable angina pectoris in the Sri Lankan population
Patients diagnosed with chronic stable angina and normal left ventricular function (EF ≥ 50%) were included in the study and underwent coronary angiography, followed by speckle-tracking echocardiography. The study measured the global longitudinal strain and analyzed its correlation with the coronary angiography findings for each patient.
A total of 78 participants were included in this study, 44(56.5%) were diagnosed with coronary artery disease. Significant differences between CAD and non-CAD groups were observed in terms of age (P - 0.003), diabetes mellitus (P - 0.02), hypertension (P - 0.004) and family history of premature CAD (P - 0.01). There was a notable decrease in GLS values among CAD patients (-17.97 ±0.85) compared to non-CAD patients (-20.26 ±1.03), with a significant decrease observed as the count of affected vessels rose (P = 0.0001). A GLS cutoff value of -19 demonstrated promising sensitivity (72.7%) and specificity (70.6%) in predicting significant CAD, supported by an AUC of 0.717 ( P = 0.001). In regression analysis, only diabetes showed a significant association with reduced GLS. GLS demonstrated a significant p-value of less than 0.001 (β -2.292 CI [-3.6594, -0.9246]) establishing it as an independent and significant predictor of the presence of significant coronary artery disease.
Assessing global longitudinal strain at rest demonstrates excellent diagnostic accuracy for detecting coronary artery disease in patients with chronic stable angina and normal systolic function.