Sensitivity and specificity of strain and strain rate imaging [measured by speckle tracking] in assessment of ischemic heart disease compared to dobutamine stress echocardiography

Background: speckle tracking echocardiography [STE] enables objective assessment of left ventricular [LV] function through analysis of myocardial strain and strain rate. This study aims to determine the sensitivity and specificity of global longitudinal strain [GLS] and global longitudinal strain rate [GLSR] of LV in assessment of myocardial Jirnction compared to peak wall motion score index [WMSI] at dobutamine stress echocardiography [DSE]

Methods: fifty patients with suspected or known myocardial ischemia were evaluated by conventional echocardiography, DSE, STE and coronary angiography [CA]. Standard apical views were wed to calculate GLS and GHR by STE. WMSI was calculated at peak stress during DSE. Significant coronary lesion[s] were indicated by >/= 50% luminal stenosis in CA

Results: GLS and GLSR were significantly lower in patients with significant CAD than those with

Conclusion: GLS and GLSR are negatively correlated to peak WMSI. Both deformation parameters can predict significant lesion[s] in CA, but with lower diagnostic accuracy than DSE

P wave dispersion and severity of obstructive sleep apnea syndrome

OSA is associated with an increased prevalence of coronary artery disease heart failure and rhythm disturbance. Also, P-wave dispersion [Pd] reflects inhomogeneous atrial depolarization secondary to insults such as chronically elevated atrial pressure, ischemia, or metabolic stress that promote atrial structure remodeling and provide a substrate for atrial fibrillation. We aimed to investigate Pd in patients with OSA and to determine if there is any relationship with severity of the disease. This study was conducted in Chest and Cardiology Departments, Assuit University Hospital, Egypt on 40 OSA patients [29 males and 11 females], and 20 healthy controls. We excluded patients with COPD and any diagnosed cardiac disease. For every patient, we did a polysomnography and ECG. Pd was significantly more in OSA [98.50 +/- 4.77 m/s] than controls [72.00 +/- 3.37 m/s] Rvalue <0.05]. Pd in severe, moderate and mild OSA were 111.43 +/- 5.62 m/s, 95.00 +/- 7.83 m/s ando5.71 +/- 8.41 m/s, respectively with a significant positive correlation with severity of OSA. Multiple linear regression shows that systolic blood pressure and BMI are independently associated with Pd [beta = 0.56, p = 0.00] [beta = 0.27, p = 0.05]. Pd is increased and correlated with severity of OSA. Systolic blood pressure and BMI are independent risk factors for Pd. Follow up of patients to detect clinical implications is recommended