TITLE:
Assessment of Left Ventricular Mechanical Function in Cardiac Syndrome X: Speckle Tracking Imaging Study
AUTHORS:
Mahmoud Kamel, Ahmed Emara, Said Shalaby Montaser, Mahmoud Said
KEYWORDS:
Cardiac Syndrome X, Left Ventricular Systolic and Diastolic Function, 2D-Speckle Tracking Strain and Strain Rate Imaging
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.8 No.12,
December
24,
2018
ABSTRACT: Objective: Early detection of LV mechanical abnormalities in patients with cardiac syndrome X (CSX) by speckle tracking echocardiography (STE). Background: Cardiac syndrome X is a triad of angina pectoris, positive stress test for myocardial ischemia and angiographically free coronary arteries. Two dimensional speckle trackingechocardiography (2D-STE) provides a more sensitive method for evaluation of global and segmental LV function than conventional two dimensional echocardiographic parameters. Subjects and Methods: Seventy patients proved to have CSX and 20 healthy control volunteers were included with a mean age of 49.43 ± 5.92 vs. 49.40 ±6.27 years respectively with no difference regarding sex for both patients and controls. Patients with hypertension, diabetes mellitus, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis and arrhythmias were excluded. All included individuals were subjected to complete conventional echocardiographic assessment and left ventricular global and segmental mechanical function was assessed using 2D based strain and strain rate (longitudinal, radial and circumferential) imaging. Results: There was no statistically significant difference in LV conventional echo parameters between patients and controls. However, global mean longitudinal strain was significantly lower in patients than controls (-15.05 ± 3.28 vs. -20.22 ± 2.49; p 0.001). For radial and circumferential strain stain, there was no significant changes between patients vs. controls (29.75 ± 18.26 vs. 28.09 ± 15.48; p = 0.74) and (-19.88 ± 8.63 vs. -21.93 ± 5.69; p 0.05) respectively. Conclusion: In spite of normal conventional echo parameters among patients and controls, LV longitudinal strain and strain rate by 2D speckle tracking imaging were lower in the patients denoting subclinical left ventricular mechanical dysfunction in patients with CSX.