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Revista argentina de cardiología
versión On-line ISSN 1850-3748
Resumen
ARBUCCI, ROSINA et al. The Behavior of Regional Longitudinal Strain Depends on Coronary Flow Reserve in a Simultaneous Analysis during Dipyridamole Stress Echocardiography. Rev. argent. cardiol. [online]. 2019, vol.87, n.6, pp.462-469. Epub 01-Nov-2019. ISSN 1850-3748. http://dx.doi.org/10.7775/rac.es.v87.i6.16486.
Background:
The behavior of regional and global longitudinal strain in relation to the value of the coronary reserve is poorly studied.
Objectives:
Compare the behavior of the Apical and global longitudinal Strain with the value of the coronary reserve of the anterior descending artery and as a secondary aim compare these responses with the visual analysis of parietal motility during Echo Stress with Dipyridamole.
Materials and methods:
Retrospective study of 179 patients (age 68.7±7.8), 90 patients (50.3%) were men. At the peak of the dipyridamole effect, the coronary reserve was measured, simultaneously with the Longitudinal Strain and the visual analisis of contractility. Two groups were divided: Group 1: Coronary reserve ≥2 and Group 2: <2. Apical Strain was defined as the average of 4 apical segments and global as the average of the 17 segments. It was considered normal any increased of deformation.
Results:
113 patients (63.12%) were included in Group 1 and 66 (36.87%) in Group 2. Strain Apical: 96.77% of Group 1 increased their strain values with the stress, while in group 2, 95.31% presented a worsening strain values (p<0.0001). Global Strain: 82.8% of Group 1 had an increase in their values, while in Group 2, 78.8% showed worsening (p<0.01). Post Dipyridamole parietal Motility Analysis: 96.46% of Group 1 had preserved parietal motility and only 54.5% of Group 2 (4 patients had increased apical Strain in this group).
Conclusions:
There was a close correlation between the coronary reserve of the anterior descending artery and the contractile reserve evaluated by regional apical longitudinal strain of the 4 apical segments, which was superior to the use of global strain. The Apical Strain showed a better correlation with ADA coronary reserve than with the visual analysis of contractility.
Palabras clave : Echocardiography, Stress/methods; Echocardiography, Doppler; Myocardial Contraction/physiology; Dipyridamole; Fractional Flow Reserve, Myocardial; Coronary Vessel/Diagnostic Imaging.