The clinical value of noninvasive left ventricular myocardial work in the diagnosis of myocardial ischemia in coronary heart disease: a comparative study with coronary flow reserve fraction

Yingjie Zhao^#^{1

2}, Furong He^#³, Weifeng Guo^#^{2

4}, Zhenyi Ge^{1

2}, Zhengdan Ge^{1

2}, Yige Lu^{5

6

7}, Guanyu Qiao^{5

6

7}, Yaoyi Zhang³, Hanbo Zhang³, Hongyan Lin³, Yao Guo^{1

2}, Yingying Jiang^{1

2}, Shihai Zhao^{2

4}, Jingyang Luan^{8

9

10}, Wei He^{11

12

13}, Cuizhen Pan^{14

15}, Xianhong Shu^{1

2}

Affiliations

¹ Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China.
² Shanghai Institute of Medical Imaging, Shanghai, China.
³ School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, China.
⁴ Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
⁵ Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
⁶ Institute of Vascular Surgery, Fudan University, Shanghai, China.
⁷ National Clinical Research Center for Interventional Medicine, Fudan University, Shanghai, China.
⁸ Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. glorialuan1995@163.com.
⁹ Institute of Vascular Surgery, Fudan University, Shanghai, China. glorialuan1995@163.com.
¹⁰ National Clinical Research Center for Interventional Medicine, Fudan University, Shanghai, China. glorialuan1995@163.com.
¹¹ Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. 16301050198@fudan.edu.cn.
¹² Institute of Vascular Surgery, Fudan University, Shanghai, China. 16301050198@fudan.edu.cn.
¹³ National Clinical Research Center for Interventional Medicine, Fudan University, Shanghai, China. 16301050198@fudan.edu.cn.
¹⁴ Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China. pan.cuizhen@zs-hospital.sh.cn.
¹⁵ Shanghai Institute of Medical Imaging, Shanghai, China. pan.cuizhen@zs-hospital.sh.cn.

^# Contributed equally.

PMID: 39096407
DOI: 10.1007/s10554-024-03208-6

Comparative Study

The clinical value of noninvasive left ventricular myocardial work in the diagnosis of myocardial ischemia in coronary heart disease: a comparative study with coronary flow reserve fraction

Yingjie Zhao et al. Int J Cardiovasc Imaging. 2024 Oct.

. 2024 Oct;40(10):2167-2179.

doi: 10.1007/s10554-024-03208-6. Epub 2024 Aug 3.

Authors

Affiliations

¹ Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China.
² Shanghai Institute of Medical Imaging, Shanghai, China.
³ School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, China.
⁴ Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
⁵ Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
⁶ Institute of Vascular Surgery, Fudan University, Shanghai, China.
⁷ National Clinical Research Center for Interventional Medicine, Fudan University, Shanghai, China.
⁸ Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. glorialuan1995@163.com.
⁹ Institute of Vascular Surgery, Fudan University, Shanghai, China. glorialuan1995@163.com.
¹⁰ National Clinical Research Center for Interventional Medicine, Fudan University, Shanghai, China. glorialuan1995@163.com.
¹¹ Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. 16301050198@fudan.edu.cn.
¹² Institute of Vascular Surgery, Fudan University, Shanghai, China. 16301050198@fudan.edu.cn.
¹³ National Clinical Research Center for Interventional Medicine, Fudan University, Shanghai, China. 16301050198@fudan.edu.cn.
¹⁴ Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China. pan.cuizhen@zs-hospital.sh.cn.
¹⁵ Shanghai Institute of Medical Imaging, Shanghai, China. pan.cuizhen@zs-hospital.sh.cn.

^# Contributed equally.

PMID: 39096407
DOI: 10.1007/s10554-024-03208-6

Abstract

The prompt and precise identification of hemodynamically significant coronary artery lesions remains an ongoing challenge. This study investigated the diagnostic value of non-invasive global left ventricular myocardial work indices by echocardiography in functional status of coronary artery disease (CAD) patients with myocardial ischemia using fractional flow reserve (FFR) as the gold standard. A total of 77 consecutive patients with clinically suspected CAD were prospectively enrolled. All participants sequentially underwent echocardiography, invasive coronary angiography (ICA) and FFR measurement. According to the results of ICA, patients were divided into myocardial ischemia group (FFR ≤ 0.8, n = 27) and non-myocardial ischemia group (FFR > 0.8, n = 50). Myocardial work indices including global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE), global positive work (GPW), global negative work (GNW), global systolic constructive work (GSCW) and global systolic wasted work (GSWW) were obtained by using the non-invasive left ventricular pressure strain loop (PSL) technique. Compared with the non-myocardial ischemia group, GWI, GCW, GPW and GSCW were significantly decreased in the myocardial ischemia group at either the 18-segment level or the 12-segment level (P < 0.001). At the 18-segment level, GWI < 1783.6 mmHg%, GCW < 1945.4 mmHg%, GPW < 1788.7 mmHg% and GSCW < 1916.5 mmHg% were optimal cut-off value to detect myocardial ischemia with an FFR ≤ 0.8. Global left ventricular myocardial work indices by echocardiography exhibited a good diagnostic value in patients with CAD and may have a good clinical significance for the screening of suspected myocardial ischemia.

Keywords: Coronary artery disease; Coronary fractional flow reserve; Echocardiography; Myocardial ischemia; Myocardial work.

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References

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The clinical value of noninvasive left ventricular myocardial work in the diagnosis of myocardial ischemia in coronary heart disease: a comparative study with coronary flow reserve fraction

Affiliations

The clinical value of noninvasive left ventricular myocardial work in the diagnosis of myocardial ischemia in coronary heart disease: a comparative study with coronary flow reserve fraction

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous