Quantitative Assessment of Myocardial deformation for Culprit Vessel Identification. | ||
| Fayoum University Medical Journal | ||
| Volume 16, Issue 1, November 2025, Pages 79-90 PDF (603.57 K) | ||
| Document Type: Full Length research Papers | ||
| DOI: 10.21608/fumj.2025.371044.1489 | ||
| Authors | ||
| Gomaa Abdelrazek Abdelrazek1; Arwa Maher El Tabey* 2; Khaled Ahmed ElKhashab2; Mostafa kamal Eldin Khalil2 | ||
| 1Associate Professor of cardiology at the Faculty of Medicine, Fayoum university, Fayoum, Egypt | ||
| 2Cardiovascular department, Faculty of medicine, Fayoum University, Fayoum, Egypt | ||
| Abstract | ||
| Introduction: Accurate identification of the culprit vessel in patients with NSTEMI is crucial for improved outcomes. two-dimensional speckle tracking echocardiography (2D-STE) offers a quantitative assessment of myocardial deformation enhancing culprit vessel prediction. Aim of the study: Evaluation of the diagnostic accuracy of 2D-STE in predicting the culprit vessel in NSTEMI patients. Subjects and Methods: This prospective observational study enrolled 120 patients presenting with NSTEMI. 2D-STE was performed. Global longitudinal strain (GLS), regional longitudinal strain (RLS) in the 17-segment model, and regional strain differences, were analyzed. Coronary angiography, the gold standard for culprit vessel identification, was performed. The diagnostic performance of 2D-STE parameters was assessed. Results: 60 patients had a culprit vessel in the LAD, 30 in the RCA, and 30 in the LCx. Segments supplied by the culprit vessel exhibited significantly reduced RLS compared to segments supplied by non-culprit vessels. The regional strain difference between the apical anterior and apical inferior segments demonstrated the highest diagnostic accuracy, with a sensitivity of 85%, specificity of 80%, and an area under the ROC curve (AUC) of 0.89. GLS also demonstrated a significant association with the presence of a culprit vessel. Patients with LAD culprit lesions had a mean GLS of -14.2%, compared to -18.5% in those with non-LAD culprit lesions (p < 0.001). Conclusions: 2D-STE provides a valuable quantitative assessment of myocardial deformation for predicting the culprit vessel in patients with NSTEMI. Incorporating 2D-STE into the clinical evaluation of NSTEMI patients may help culprit vessel identification and guide revascularization strategies. | ||
| Keywords | ||
| Speckle Tracking Echocardiography; Myocardial Strain; NSTEMI; Culprit Vessel; Coronary Angiography | ||
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