The Predictive Capabilities Speckle Tracking Echocardiography in Patients with Severe Ischemic Left Ventricle Dysfunction

Natalia Bikbova ¹, Ivan Klyuchnikov  ², Nadezda Kharitonova ¹, Marat Sagirov ¹, Jacob Brand ¹

¹ N.V.Sklifosovsky Research Institute of Emergency Medicine , Moscow, Russia; ² A.N. Bakoulev Scientific Center for Cardiovascular Surgery , Moscow, Russia;

Date, time and location: 2018.05.26 17:00, Exhibition area, 1st Floor. Zone – A

Abstract

Quantitative evaluation of myocardial deformation with speckle-tracking echocardiography (STE) technique can give additional prognostic information for myocardial revascularization in patients with severe ischemic myocardial dysfunction.

The purpose of the study was to estimate the clinical and functional prognosis in patients with coronary heart disease (CHD) and low ejection fraction (EF) drawing on the trends in the longitudinal strain before and after the CABG.

Materials and methods: 45 male patients were enrolled. The coronary angiography showed multivessel disease in all patients. All patients underwent standard transthoracic echocardiography and speckle-tracking echocardiography to evaluate the longitudinal strain, as well as to assess the symptoms of chronic heart failure, according to the NYHA classification before and 6 months after the CABG. Baseline EF of LV was 34.6% ± 5.5. The wall motion score index (WMSI) was 2.0 ± 0.25. The mean global longitudinal strain was - 9.8% ± 3.9. All patients underwent the CABG.

Results: Six months after the surgery, the patients were divided into two groups, depending on the clinical data: Patients with positive trend (91.1%) and patients without significant trend of CHF symptoms (8.9%). All patients had correlations of the baseline indices of the longitudinal strain and the trends of CHF symptoms after the syrgery. If the baseline global longitudinal strain was less than - 6.3%, there was a lack of significant positive trends in CHF symptoms in the postoperative period.

The predictive significance of the regional longitudinal strain index was also evaluated: if the baseline value was - 5.2%, there was no reliable increase of this index after the surger.

Conclusions: longitudinal sistolic strain is a reliable quantitative measure of the LV systolic function. The speckle-tracking echocardiography can be used to determine if surgical revascularization is suitable in patients with CHD and low LV EF.