ISSN: 1859 - 2872
Characteristics of left ventricular global longitudinal strain on echocardiography and its association with coronary artery lesions in patients with stable angina at the outpatient clinic of Huu Nghi Hospital
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Abstract
Objective: To describe the characteristics of left ventricular global longitudinal strain (GLS) and to evaluate the association between regional longitudinal strain and coronary artery lesion location on coronary computed tomography angiography (CCTA) or invasive coronary angiography (ICA) in patients with stable angina. Subject and method: A cross-sectional descriptive study was conducted on 50 patients diagnosed with stable angina at the outpatient cardiology clinic of Huu Nghi Hospital from September to December 2024. All patients underwent two-dimensional speckle-tracking echocardiography (2D-STE) to assess global and regional GLS, and CCTA or ICA to determine the severity and location of coronary artery stenosis. Correlation analyses and diagnostic performance evaluation (sensitivity, specificity, ROC curves) were performed to examine the relationship between regional GLS and corresponding coronary artery lesions. Result: The mean age of the cohort was 76.08 ± 8.08 years, with a male-to-female ratio of 4.6:1; 44% of patients had no obstructive coronary artery disease (suspected ANOCA/INOCA). The mean GLS was -16.00 ± 3.36, while the mean ejection fraction (EF) was 58.44 ± 9.18. No significant difference in GLS was observed among patients with one-, two-, or three-vessel coronary disease. Diagnostic performance varied substantially across myocardial regions: apical segments (LAD territory) demonstrated high specificity (93.75%) at a cut-off ≥ -16. Lateral wall segments (LCX territory) also showed high specificity (89.29%) at a cut-off ≥ -12, though sensitivity remained low (35%). Other regions demonstrated modest diagnostic value (AUC 0.54 - 0.62). Conclusion: In elderly patients with stable angina, GLS is more sensitive than EF for detecting early left ventricular dysfunction. Regional GLS has value in localizing ischemic segments, especially apical strain in LAD disease, though its overall diagnostic accuracy is modest; thus, it should be considered an adjunctive tool in clinical practice.
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