Author + information
- Şükrü Taylan Şahin1,
- Selen Yurdakul2,
- Betul Cengiz1,
- Ayşen Bozkurt1,
- Ebru Özenç2,
- Vedat Aytekin1 and
- Saide Aytekin1
Based on current literature, coronary artery anomalies (CAA) are classified as benign and potentially serious coronary anomalies. Although most of CAA are classified as benign and asymptomatic, it can cause myocardial ischemia without atherosclerosis. In the present study, we aimed to evaluate subclinical left ventricular (LV) systolic dysfunction in patients with CAA, without any cardiovascular disease and with preserved ejection fraction (EF), by using two strain imaging methods, “speckle tracking echocardiography ” (STE) and “velocity vector imaging” (VVI).
We studied 25 patients with CAA (age 58.44±10.57 years, 45% female) and 20 age and sex-matched control subjects, without any cardiac disease and with normal LV EF. Among 25 patients, 15 had anomalous origin of left circumflex (LCx) artery, 10 had anomalous origin of right coronary artery (RCA). Conventional echocardiography and 2- dimensional (2D) strain imaging were performed to analyze subclinical LV systolic function.
Conventional echocardiographic measurements (LV end diastolic diameter, LV end systolic diameter and LV EF) were similar between the groups. Based on VVI analysis, LV longitudinal peak systolic strain (13.14±1.59% to 23.43±1.77%, p=0.0001) and strain rate (0.46±0.09 1/s to 4.56±0.76 1/s, p=0.0001) were significantly impaired in patients with CAA, compared to controls. Regarding STE, LV longitudinal peak systolic strain (13.05±1.25% to 17.37±2.39%, p=0.0001) and strain rate (0.38±0.09 1/s to 1.34±0.33 1/s, p=0.0001) were also markedly impaired in patients with CAA. When we correlated the two distinct 2D strain imaging modalities, we obtained a significant positive correlation. (r=0.785, p=0.0001 for strain; r=0.931, p=0.0001 for strain rate measurements).
It may be essential to assess the subtle changes in LV myocardial contractility in patients with CAA, because clinical consequences may be of particular importance. 2D strain imaging-based novel echocardiographic techniques may provide additional data for detecting preclinical systolic dysfunction in patients with CAA.