Comparison of myocardial perfusion scintigraphy and strain echocardiography in patients undergoing coronary angiography

TL;DR

This study compares two heart imaging techniques to detect coronary artery disease and finds them similarly effective.

Contribution

The study introduces a new correlation between global longitudinal strain and myocardial perfusion scintigraphy for coronary artery disease detection.

Findings

Ischemic percentages >12% and global longitudinal strain <-18.4% correlate with true positive coronary angiography results.

Higher ischemic percentages negatively correlate with global longitudinal strain, indicating greater likelihood of coronary artery disease.

Female sex is associated with fewer true positive myocardial perfusion scintigraphy results.

Abstract

Myocardial perfusion scintigraphy is a common non-invasive method for assessing ischemic burden, though artifacts can affect accuracy. Speckle-tracking strain echocardiography improves left ventricular function assessment, and global longitudinal strain correlates well with coronary artery disease. The aim of this study was to compare myocardial perfusion scintigraphy with global longitudinal strain in stable angina pectoris patients.

A total of 133 suspected coronary artery disease patients who underwent myocardial perfusion scintigraphy and coronary angiography were prospectively enrolled and classified as myocardial perfusion scintigraphy true positives or false positives based on coronary angiography results. Global longitudinal strain values for the epicardium, endocardium, and myocardium (avg) were calculated.

Ischemic percentages of myocardial perfusion scintigraphy>12% and mid-wall global longitudinal strain<-18.4% correlated with true positive coronary angiography results. Left ventricular ejection fraction/global longitudinal strain mid ratio positively correlated with coronary artery disease presence and severity. Higher ischemic percentages of myocardial perfusion scintigraphy showed a negative correlation (r: −0.2606, p: 0.002) with global longitudinal strain, indicating a greater likelihood of coronary artery disease (OR 0.25, 95%CI 0.08–0.73, p: 0.012). Female sex was linked to fewer true positive myocardial perfusion scintigraphy results.

The GLS value of the Left Ventricle obtained by two-dimentional strain echocardiography offers sensitivity and specificity similar to myocardial perfusion scintigraphy in the detection of coronary artery disease.. An elevated left ventricular ejection fraction/global longitudinal strain ratio is a significant predictor of the presence and severity of coronary artery disease.