Postsystolic shortening on echocardiography as a gateway to cardiac computed tomography in patients with suspected stable angina pectoris
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Postsystolic shortening on echocardiography as a gateway to cardiac computed tomography in patients with suspected stable angina pectoris. / Brainin, Philip; Olsen, Flemming Javier; Lassen, Mats Christian Højbjerg; Bech, Jan; Claggett, Brian; Fritz-Hansen, Thomas; Folke, Fredrik; Gislason, Gunnar H; Biering-Sørensen, Tor.
In: International Journal of Cardiovascular Imaging, Vol. 36, No. 2, 2020, p. 309-316.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Postsystolic shortening on echocardiography as a gateway to cardiac computed tomography in patients with suspected stable angina pectoris
AU - Brainin, Philip
AU - Olsen, Flemming Javier
AU - Lassen, Mats Christian Højbjerg
AU - Bech, Jan
AU - Claggett, Brian
AU - Fritz-Hansen, Thomas
AU - Folke, Fredrik
AU - Gislason, Gunnar H
AU - Biering-Sørensen, Tor
PY - 2020
Y1 - 2020
N2 - Postsystolic shortening (PSS) by speckle-tracking echocardiography (STE) is a marker of myocardial ischemia and may improve diagnostic strategy. We sought to evaluate if PSS is associated with the coronary artery calcium score (CACS) and stenosis by computed tomography angiography (CTA) in patients with suspected stable angina pectoris (SAP). We retrospectively studied 437 SAP patients (age 58 ± 11 years, 41% male) who underwent STE, evaluation of CACS and assessment of significant stenosis (≥ 50%) by CTA. The postsystolic index (PSI) was defined as follows: 100x([peak negative strain cardiac cycle - peak negative strain systole])/peak negative strain cardiac cycle. A wall had PSS if any segment within the wall had a PSI ≥ 20%. We defined categories for walls with PSS: 0, 1, 2 and ≥ 3, and CACS: 0, 1-100, 101-400 and > 400. Each additional wall with PSS was associated with a 43% relative increase in CACS (95%CI +9% to +87%, P = 0.010), while each 1% absolute increase in the PSI was associated with a 9% relative increase in CACS (95%CI +1% to +18%, P = 0.031). Walls with PSS (OR 1.81 per 1 wall increase, 95%CI 1.27-2.59, P = 0.001) and the PSI (OR 1.12 per 1% increase, 95%CI 1.04-1.21, P = 0.004) were associated with the occurrence of CACS > 400. Additionally, walls with PSS (OR 1.53 per 1 wall increase, 95%CI 1.21-1.93, P < 0.001) was a predictor of significant stenosis by CTA. PSS is associated with CACS and significant stenosis by CTA in patients with SAP and may aid in the selection of patients referred for cardiac computed tomography.
AB - Postsystolic shortening (PSS) by speckle-tracking echocardiography (STE) is a marker of myocardial ischemia and may improve diagnostic strategy. We sought to evaluate if PSS is associated with the coronary artery calcium score (CACS) and stenosis by computed tomography angiography (CTA) in patients with suspected stable angina pectoris (SAP). We retrospectively studied 437 SAP patients (age 58 ± 11 years, 41% male) who underwent STE, evaluation of CACS and assessment of significant stenosis (≥ 50%) by CTA. The postsystolic index (PSI) was defined as follows: 100x([peak negative strain cardiac cycle - peak negative strain systole])/peak negative strain cardiac cycle. A wall had PSS if any segment within the wall had a PSI ≥ 20%. We defined categories for walls with PSS: 0, 1, 2 and ≥ 3, and CACS: 0, 1-100, 101-400 and > 400. Each additional wall with PSS was associated with a 43% relative increase in CACS (95%CI +9% to +87%, P = 0.010), while each 1% absolute increase in the PSI was associated with a 9% relative increase in CACS (95%CI +1% to +18%, P = 0.031). Walls with PSS (OR 1.81 per 1 wall increase, 95%CI 1.27-2.59, P = 0.001) and the PSI (OR 1.12 per 1% increase, 95%CI 1.04-1.21, P = 0.004) were associated with the occurrence of CACS > 400. Additionally, walls with PSS (OR 1.53 per 1 wall increase, 95%CI 1.21-1.93, P < 0.001) was a predictor of significant stenosis by CTA. PSS is associated with CACS and significant stenosis by CTA in patients with SAP and may aid in the selection of patients referred for cardiac computed tomography.
KW - Aged
KW - Angina, Stable/diagnostic imaging
KW - Computed Tomography Angiography
KW - Coronary Angiography/methods
KW - Coronary Artery Disease/diagnostic imaging
KW - Coronary Stenosis/diagnostic imaging
KW - Echocardiography, Doppler, Pulsed
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Multidetector Computed Tomography
KW - Predictive Value of Tests
KW - Retrospective Studies
KW - Severity of Illness Index
KW - Systole
KW - Vascular Calcification/diagnostic imaging
KW - Ventricular Function, Left
U2 - 10.1007/s10554-019-01724-4
DO - 10.1007/s10554-019-01724-4
M3 - Journal article
C2 - 31705226
VL - 36
SP - 309
EP - 316
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
SN - 1569-5794
IS - 2
ER -
ID: 257547748