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The following is a summary of “Subtle echocardiographic markers of CAD: looking beyond the LV ejection fraction in stable angina patients,” published in the October 2024 issue of Cardiology by Khare et al.    

Echocardiograms primarily identify regional wall motion abnormalities (RWMA) and left ventricular diastolic dysfunction (LVDD) to diagnose coronary artery disease (CAD), often labeling studies as “normal” when these markers are absent.  

Researchers conducted a prospective study to identify subtle echocardiographic markers of CAD in patients with stable angina.  

They assessed LV systolic and diastolic parameters and left atrial (LA) strain parameters through echocardiography in 103 patients with stable angina undergoing coronary angiography and compared these with the SYNTAX score-II (SS-II).  

The results showed that left ventricular global longitudinal strain (LV-GLS) and left atrial volume indexed (LAVi) did not significantly correlate with the SYNTAX score-II (SS-II). The ratio of early mitral inflow velocity to early mitral annular velocity (E/e’) increased significantly with SS-II, with a cutoff value >10.39 for significant coronary artery disease (P<0.001), LA reservoir function parameters, peak atrial longitudinal strain (PALS) and peak global systolic strain rate (LAsSR) decreased significantly with increasing SS-II (P=0.011 and P=0.001, respectively). Values <23.56 for PALS and <1.15 for LAsSR were significantly associated with CAD. The LA conduit function parameter, peak global early diastolic strain rate (LAeSR), also increased significantly with increasing SS-II (P<0.001), with values >1.09 showing a good correlation with CAD.  

The study concluded that LV diastolic and LA strain parameters can be potential echocardiographic markers for CAD in patients with stable angina.

Source: link.springer.com/article/10.1007/s00392-024-02561-9