Journal of clinical medicine · 2022
Vasodilator Strain Stress Echocardiography in Suspected Coronary Microvascular Angina.
СтатьяНазвание и аннотация: Перевод в очереди
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Rodriguez-Zanella Hugo, Arbucci Rosina, Fritche-Salazar Juan Francisco, Ortiz-Leon Xochitl Arely, Tuttolomondo Domenico, Lowenstein Diego Haber, Wierzbowska-Drabik Karina, Ciampi Quirino, Kasprzak Jarosław D, Gaibazzi Nicola, Lowenstein Jorge, Posada-Martinez Edith Liliana, Arias-Godinez Jose Antonio, de la Fuente-Mancera Juan C, Picano Eugenio, On Behalf Of The Stress Echo Study Group Of The Italian Society Of Echocardiography And Cardiovascular Imaging Siecvi
Аннотация
Background: In patients with Ischemia and non-obstructive coronary artery stenosis (INOCA) wall motion is rarely abnormal during stress echocardiography (SE). Our aim was to determine if patients with INOCA and reduced coronary flow velocity reserve (CVFR) have altered cardiac mechanics using two-dimensional speckle-tracking echocardiography (2DSTE) during SE. Methods: In a prospective, multicenter, international study, we recruited 135 patients with INOCA. Overall, we performed high dose (0.84 mg/kg) dipyridamole SE with combined assessment of CVFR and 2DSTE. The population was divided in patients with normal CVFR (>2, group 1, n = 95) and abnormal CVFR (≤2, group 2, n = 35). Clinical and 2DSTE parameters were compared between groups. Results: Feasibility was high for CFVR (98%) and 2DSTE (97%). A total of 130 patients (mean age 63 ± 12 years, 67 women) had complete flow and strain data. The two groups showed similar 2DSTE values at rest. At peak SE, Group 1 patients showed lower global longitudinal strain (p < 0.007), higher mechanical dispersion (p < 0.0005), lower endocardial (p < 0.001), and epicardial (p < 0.0002) layer specific strain. Conclusions: In patients with INOCA, vasodilator SE with simultaneous assessment of CFVR and strain is highly feasible. Coronary microvascular dysfunction is accompanied by an impairment of global and layer-specific deformation indices during stress.