Detection of Obstructive Coronary Artery Disease Using Peak Systolic Global Longitudinal Strain Derived by Two-Dimensional Speckle-Tracking: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 29 (8) ◽  
pp. 724-735.e4 ◽  
Author(s):  
Kevin Liou ◽  
Kazuaki Negishi ◽  
Suyen Ho ◽  
Elizabeth A. Russell ◽  
Greg Cranney ◽  
...  
Keyword(s):  
Systematic Review ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Meta Analysis ◽  
Obstructive Coronary Artery Disease ◽  
Global Longitudinal Strain ◽  
Two Dimensional ◽  
Artery Disease

scholarly journals Coronary Computed Tomography Angiography in Diagnosing Obstructive Coronary Artery Disease in Patients with Advanced Chronic Kidney Disease: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-8
Author(s):  
Xingxing S. Cheng ◽  
Suman Mohanty ◽  
Valery Turner ◽  
Domenico Mastrodicasa ◽  
Simon Winther ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Sensitivity And Specificity ◽  
Coronary Computed Tomography Angiography ◽  
Meta Analysis ◽  
Obstructive Coronary Artery Disease ◽  
Artery Disease

<b><i>Introduction:</i></b> Coronary computed tomography angiography (CCTA) is emerging as an important noninvasive testing modality for coronary angiography. The performance characteristic of CCTA in patients with advanced kidney disease is unknown. <b><i>Methods:</i></b> We performed a systematic review and meta-analysis of studies specifically investigating the sensitivity and specificity of CCTA compared to coronary angiogram as a reference standard in patients with advanced kidney disease, defined as dialysis dependence or nearing kidney transplantation. Two independent investigators assessed studies for inclusion/exclusion, quality, and characteristics, while a third investigator adjudicated. <b><i>Results:</i></b> We identified 4 studies including a total of 217 patients, of whom 159 were dialysis dependent. Three of the 4 studies had a high risk of bias in patient selection and study flow, while 1 study rated low in all areas of bias. The studies were heterogeneous in their patient selection and CCTA protocol but consistent in their definition of obstructive coronary artery disease. The pooled sensitivity and specificity for CCTA were 0.96 (0.87–0.99) and 0.66 (0.57–0.74), respectively. When we restricted the analysis to dialysis-dependent patients, the pooled sensitivity and specificity for CCTA were 0.99 (0.74–1.00) and 0.67 (0.49–0.82), respectively. <b><i>Conclusions:</i></b> Based on limited data, CCTA appears to have comparable sensitivity but lower specificity relative to the non-kidney disease population.

scholarly journals Role of global longitudinal strain diastolic index in assessment of patients with suspected obstructive coronary artery disease and normal or mildly reduced ejection fraction

2020 ◽  
Vol 30 (2) ◽  
pp. 222-229
Author(s):  
Mihaela Bolog ◽  
Mihaela Dumitrescu ◽  
Florentina Romanoschi ◽  
Elena Pacuraru ◽  
Alina Rapa
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Obstructive Coronary Artery Disease ◽  
Global Longitudinal Strain ◽  
Strain Imaging ◽  
Control Group ◽  
Reduced Ejection Fraction ◽  
Artery Disease

Objective – To examine the utility of global longitudinal strain imaging diastolic index (SI-DI) in the assessment of patients with suspected obstructive coronary artery disease (CAD). Methods – We performed rest 2D standard echocardiography and strain imaging in 30 healthy subjects and in 148 patients with normal or mildly reduced ejection fraction and indication for coronarography for suspected obstructive CAD. Standard echocardiographic and strain parameters were analysed. Results – Global SI-DI was signifi cantly lower in the selected vs control group (p <0.001). After coronarography patients were divided in three subgroups: 74 patients with more than 50% obstruction in any major artery, 26 patients with previous revascularisation but no significant obstructive lesions at present and 48 patients without obstructive artery disease. Average global SI-DI was significantly lower in the subgroup with obstructive CAD vs the other two subgroups (p<0.05). Global SI-DI lower than 0.5 had a good sensitivity (84%) and a reasonable positive predictive value (52%) for detection of obstructive CAD. Conclusions – Global SI-DI is significantly lower in patients with obstructive CAD and normal or mildly reduced ejection fraction compared with normal subjects. A cut off value lower than 0.5 selects patients with a higher probability of obstructive CAD.

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