Author + information
Carotid intima-media thickness (CIMT) is a non-invasive, inexpensive, reliable marker of coronary artery disease (CAD). LV global longitudinal strain function ( LV GLS) can be accurately assessed by 2D speckle-tracking strain echocardiography (2D-STE).
To assess the relationship between carotid IMT and left ventricular global longitudinal strain (LV GLS) assessed by 2D speckle-tracking strain echocardiography (2D-STE) in patients with CAD. It also aimed to assess the ability of both LV global longitudinal strain (LV GLS) and carotid IMT to predict CAD severity.
It included 156 patients with suspected CAD by history of angina admitted electively for coronary angiography (CA). We excluded patients with acute coronary syndrome and concomitant disease or drug therapy which affect cardiac function. Patients underwent transthoracic echocardiography (TTE), (2D-STE), B-mode ultrasound of the carotid arteries and coronary angiography. The patients were divided into two groups: group 1 (106 patients) with significant (>70%) CAD, and group 2 (50 patients) (<70%). Examinations included measurements of cardiac dimensions and LV ejection fraction. Images were obtained for the global peak systolic longitudinal strain (PSLS). Measurement of CIMT was performed at the far wall of the common carotid artery (CCA) 1cm proximal to the bifurcation.
There were significant increase in the mean CIMT and significant decrease in GLS in group 1 compared to group 2 (1.43 ± 0.41 vs 0.72 ± 0.4, p < 0.001), and (-12.2± 2.93 vs -16.65 ± 3.5, p < 0.001) respectively. The cut-off value for LVGLS less than -15.8 % using ROC curve was a predictor of significant CAD with AUC 0.82, 95%CI 0.71 - 0.94, p < 0.001. The sensitivity, specificity and accuracy of GLS for detecting significant CAD were 96.2%, 68.0%, and 87.2% respectively. The cut-off value of the CIMT > 1.1 mm using ROC curve was a predictor of significant CAD with AUC 0.89, 95% CI 0.81-0.96, p < 0.001. The sensitivity, specificity and accuracy of mean CIMT was 92.5%, 84.0% and 89.7%. There was significant negative correlation between global LVGLS and mean carotid IMT (r = - 0.88, p < 0.0001 and positive correlation with EF (r = 0.37, p = 0.001).
Increased CIMT was associated with decreased LV function assessed by 2D strain echocardiography. Decreased GLS and increased CIMT were associated with significant CAD; So these findings support the use of CIMT measurements to predict subclinical LV dysfunction and the risk of CAD.