Association of resting left ventricular global longitudinal strain with myocardial perfusion abnormalities evaluated by 13N-ammonia positron emission tomography in patients with stable angina pectoris and normal left ventricular ejection fraction

Sayuri Yamabe, Akira Yamada, Yuka Kawada, Sayano Ueda, Naoki Hoshino, Meiko Hoshino, Kayoko Takada, Eirin Sakaguchi, Ryuta Ito, Motohiko Kakuno, Takashi Sakakibara, Satoru Ohshima, Masayoshi Sarai, Hideo Izawa

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: Little is known about whether resting left ventricular global longitudinal strain (GLS) impairment is associated with myocardial perfusion abnormalities evaluated using 13N-ammonia positron emission tomography (13N-NH3-PET)-myocardial perfusion imaging (MPI). This study aimed to investigate the correlation between resting GLS and myocardial perfusion parameters in patients with a normal left ventricular ejection fraction (LVEF). We evaluated whether resting GLS can predict myocardial perfusion abnormalities in these patients. Methods and Results: We selected 157 patients with suspected stable angina pectoris who underwent both ATP-stress NH3-PET-MPI and 2-dimentional speckle tracing echocardiography. All subjects had a preserved LVEF and no known history of myocardial infarction. Patients were stratified into Group N (normal perfusion; summed stress score [SSS], 0–3; n = 101), Group M (mildly to moderately abnormal perfusion; SSS, 4–11; n = 41), or Group S (severely abnormal perfusion; SSS, 12+; n = 15). GLS was more impaired as myocardial perfusion abnormality severity increased (–17.9 ± 2.9% for Group N, –16.8 ± 3.1% for Group M, and –14.2 ± 3.5% for Group S; p <.001). GLS was weakly but significantly correlated with SSS (R =.32, p <.001), summed difference score (R =.32, p <.001), and myocardial blood flow during stress (R = –0.27, p <.001). Multivariate logistic regression analysis showed that male sex, diabetes mellitus, systolic blood pressure, and GLS were independent predictors of myocardial perfusion abnormality defined as Groups M and S. Additionally, the area under the curve for GLS for detecting myocardial perfusion abnormality was.65, and the optimal cutoff value for GLS was –16.5%, with sensitivity and specificity of 59% and 66%, respectively. Conclusion: In patients with suspected angina pectoris, resting GLS impairment despite a normal LVEF might aid the detection of hemodynamically significant coronary artery disease.

Original languageEnglish
Pages (from-to)1555-1562
Number of pages8
JournalEchocardiography
Volume39
Issue number12
DOIs
Publication statusPublished - 12-2022

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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