2d Strain Analysis in Negative Stress Echocardiogram with Dipyridamole in Patients with Structural Normally Hearts: Could it add Much to Human Eye Analysis

Dipyridamole stress echocardiogram is widely used for detection and localization of ischemia. One of the main limitations of this exam is the fact that interpretation of results is qualitative, remaining in human eye detection of Wall motion changes. Speckle-tracking strain can be an important tool to overcome this limitation allowing to quantify myocardial deformation. There is few research in this area, mainly using dobutamin where strain reduction from basal to peak analysis seems to be associated with significative coronary disease.
With this work we intended to evaluate if there is reduction of global longitudinal strain from basal to peak images in any negative stress echocardiogram with dipyridamole and if those patients had more cardiovascular events. We analyze all stress echocardiogram performed in 2014 and 2015 with good acustic window and structuraly normal heart. We selected 31 patients (mean age 65.6±10.4, 80.6% males). Mean longitudinal strain in basal images was 21.01±1.99 and peak images was 23.86±2.38. Patients with previous myocardial infarction had lower mean longitudinal strain in basal images (19.68±1.32, p=0.09). We didn’t found reduction of strain in any patient from basal to peak images and follow-up didn’t show cardiovascular events.
These results may be limited by the number os patients included and short follow-up but it can also show that in patients with good acustic window, strain analysis won’t add much to qualitative evaluation done by an experient cardiologist.