TY - JOUR
T1 - The relationship between coronary artery calcium and layer-specific global longitudinal strain in patients with suspected coronary artery disease
AU - Frimodt-Møller, Emilie Katrine
AU - Olsen, Flemming Javier
AU - Lassen, Mats Christian Højbjerg
AU - Skaarup, Kristoffer Grundtvig
AU - Brainin, Philip
AU - Bech, Jan
AU - Folke, Frederik
AU - Fritz-Hansen, Thomas
AU - Gislason, Gunnar
AU - Biering-Sørensen, Tor
N1 - © 2024 Wiley Periodicals LLC.
PY - 2024/2
Y1 - 2024/2
N2 - PURPOSE: Layer-specific global longitudinal strain (GLS) may provide important insights in patients with suspected coronary artery disease (CAD). We aimed to investigate the association between layer-specific GLS and coronary artery calcium score (CACS) in patients suspected of CAD.METHODS: We performed a retrospective study of patients suspected of CAD who underwent both an echocardiogram and cardiac computed tomography (median 42 days between). Layer-specific (endocardial-, whole-layer-, and epicardial-) GLS was measured using speckle tracking echocardiography. We assessed the continuous association between layer-specific GLS and CACS by negative binomial regression, and the association with high CACS (≥400) using logistic regression.RESULTS: Of the 496 patients included (mean age 59 years, 56% male), 64 (13%) had a high CACS. Those with high CACS had reduced GLS in all layers compared to those with CACS < 400 (endocardial GLS: -20.5 vs. -22.7%, whole-layer GLS: -17.7 vs. -19.4%, epicardial GLS: -15.3 vs. -16.9%, p < .001 for all). Negative binomial regression revealed a significant continuous association showing increasing CACS with worsening GLS in all layers, which remained significant after multivariable adjustment including SCORE chart risk factors. All layers of GLS were associated with high CACS in univariable analyses, which was consistent after multivariable adjustment (endocardial GLS: OR = 1.11 (1.03-1.20); whole-layer GLS: OR = 1.14 (1.04-1.24); epicardial GLS: OR = 1.16 (1.05-1.29), per 1% absolute decrease).CONCLUSION: In this study population with patients suspected of CAD and normal systolic function, impaired layer-specific GLS was continuously associated with increasing CACS, and decreasing GLS in all layers were associated with presence of high CACS.
AB - PURPOSE: Layer-specific global longitudinal strain (GLS) may provide important insights in patients with suspected coronary artery disease (CAD). We aimed to investigate the association between layer-specific GLS and coronary artery calcium score (CACS) in patients suspected of CAD.METHODS: We performed a retrospective study of patients suspected of CAD who underwent both an echocardiogram and cardiac computed tomography (median 42 days between). Layer-specific (endocardial-, whole-layer-, and epicardial-) GLS was measured using speckle tracking echocardiography. We assessed the continuous association between layer-specific GLS and CACS by negative binomial regression, and the association with high CACS (≥400) using logistic regression.RESULTS: Of the 496 patients included (mean age 59 years, 56% male), 64 (13%) had a high CACS. Those with high CACS had reduced GLS in all layers compared to those with CACS < 400 (endocardial GLS: -20.5 vs. -22.7%, whole-layer GLS: -17.7 vs. -19.4%, epicardial GLS: -15.3 vs. -16.9%, p < .001 for all). Negative binomial regression revealed a significant continuous association showing increasing CACS with worsening GLS in all layers, which remained significant after multivariable adjustment including SCORE chart risk factors. All layers of GLS were associated with high CACS in univariable analyses, which was consistent after multivariable adjustment (endocardial GLS: OR = 1.11 (1.03-1.20); whole-layer GLS: OR = 1.14 (1.04-1.24); epicardial GLS: OR = 1.16 (1.05-1.29), per 1% absolute decrease).CONCLUSION: In this study population with patients suspected of CAD and normal systolic function, impaired layer-specific GLS was continuously associated with increasing CACS, and decreasing GLS in all layers were associated with presence of high CACS.
KW - Humans
KW - Male
KW - Middle Aged
KW - Female
KW - Coronary Artery Disease/diagnostic imaging
KW - Calcium
KW - Retrospective Studies
KW - Global Longitudinal Strain
KW - ROC Curve
KW - Predictive Value of Tests
KW - Coronary Angiography/methods
UR - http://www.scopus.com/inward/record.url?scp=85185135793&partnerID=8YFLogxK
U2 - 10.1111/echo.15775
DO - 10.1111/echo.15775
M3 - Journal article
C2 - 38353468
SN - 0742-2822
VL - 41
SP - e15775
JO - Echocardiography (Mount Kisco, N.Y.)
JF - Echocardiography (Mount Kisco, N.Y.)
IS - 2
M1 - e15775
ER -