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Diastolic Stunning as a Marker of Severe Coronary Artery Stenosis: Analysis by Speckle Tracking Radial Strain in the Resting Echocardiogram
Author(s) -
Kaseno Hiroyo,
Toyama Takuji,
Okaniwa Hiroki,
Toide Hiroyuki,
Yamashita Eiji,
Kawaguchi Ren,
Adachi Hitoshi,
Hoshizaki Hiroshi,
Oshima Shigeru
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12999
Subject(s) - cardiology , medicine , stenosis , diastole , radial artery , strain (injury) , radial stress , artery , blood pressure , physics , mechanics , velocity vector
Background Two‐dimensional speckle tracking (2 DST ) stress echocardiography detects postischemic myocardial diastolic stunning. However, the use of 2 DST at rest for detecting diastolic stunning in ischemia is unclear. Results Thirty‐nine patients (age = 65 ± 12 years; male/female = 34/5) with effort angina pectoris that was confirmed by stress myocardial perfusion scintigraphy were enrolled. Ischemic area (I) was determined in the middle LV short axial view using stress myocardial scintigraphy. The area opposite to it was defined as nonischemic area (non‐I). Midventricular parasternal short‐axis ( SAX ) radial strains were estimated using 2 DST at rest on the following day. LV diastolic function was evaluated using diastolic index ( DI , changes in the regional LV radial strain during diastole) and radial strain rate ( SR ) during early diastolic period. These parameters were compared between I and non‐I before and 1 month after percutaneous coronary intervention ( PCI ) in the I of 3 coronary vessels. For the I, the DI was lower (38 ± 27 vs. 55 ± 27; P = 0.003) and SR was higher (−1.6 ± 0.6 vs. −1.9 ± 0.8; P = 0.007) than in non‐I before PCI . One month after PCI , the DI and SR recovered to 53 ± 27 (P = 0.008) and −2.1 ± 0.8 (P = 0.006), respectively. Furthermore, the DI of the LAD and LCX significantly improved (P = 0.0004 and 0.002, respectively); the RCA area showed tendency to improve (P = 0.092), and the SR also improved (P < 0.05) in all areas after PCI . Conclusion Diastolic stunning in ischemic areas can be detected using 2 DST at rest and recover 1 month after PCI .