Prognostic value of two-dimensional strain in early ischemic heart disease: A 5-year follow-up study

Introduction: Two-dimensional strain echocardiography (2D-SE) is a reliable method formeasuring deformation of the left ventricle. Aim of the study: Aim of the study was to determine changes in 2D-SE parameters over time collected during dipyridamole stress echo-cardiography (dipy-stress) and prognosis of patients with non-diagnostic dipy-stress results. Methods: In the first phase of the study, assessment of a prospective enrolled population with a non-diagnostic dipy-stress test result was conducted, checking through coronary CT angiography (CCTA) the presence of coronary artery disease (CAD). In the follow-up phase, an echocardiographic re-evaluation and outcome analysis during amean follow-up of 78 months was carried out. Results: In the first phase, Global Circumferential Strain (GCS) values were similar in the CCTA positive and CCTA negative groups at rest and after stress. For Global Longitudinal Strain (GLS), there was a significant reduction (p < .0001) in the CCTA positive group compared to the CCTA negative group. After 78 ± 9 months none of the enrolled patients experimented cardiac events. Values of GCS, both at rest and after stress, did not differ statistically comparing follow-up values with baseline ones. No statistically significant changes were seen in the same analysis for GLS rest and stress values, between baseline and follow-up in the two groups. Conclusions: Performing 2D-SE during dipy-stress can detect mild CAD that conventional stress-testsmiss. Patients with mild coronary stenosismay have a favorablemidterm prognosis, but efforts should bemade to investigate the decrease trend inGLS, at rest and after stress, reported in this patient group.