Resting Global Longitudinal Strain as a Noninvasive Diagnostic Tool in Predicting Significant Coronary Artery Disease in Patients with Non-ST-Elevation MI and Normal Left Ventricular Systolic Function on Echocardiography

Abstract

Objectives: This study aimed to assess the relationship between resting global longitudinal strain (GLS) and significant coronary artery disease (CAD) in patients with Non-ST Elevation Myocardial Infarction (NSTEMI) and normal ejection fraction (EF).

Methodology: We enrolled 108 patients with NSTEMI and normal EF in this observational cross-sectional study. Resting GLS was measured, and coronary angiography was performed to assess CAD. The relationship between significant CAD and GLS was analyzed using the chi-square test. The specificity, sensitivity, positive predictive value, negative predictive value, and accuracy of GLS in predicting CAD were calculated.

Results: The mean age of the patients was 49.05 ± 7.28 years. The study had a male predominance. Diabetes was present in 30 patients (27.8%), hypertension in 31 patients (28.7%), dyslipidemia in 19 patients (17.6%), and 65 patients (60.2%) were smokers. Normal strain was observed in 36 patients (33.3%), while 72 patients (66.7%) had reduced strain. Significant CAD was present in 72 patients (66.7%). The p-value for the association between significant CAD and reduced GLS was <0.01. The sensitivity, specificity, and accuracy of GLS in predicting CAD were 91.7%, 83.3%, and 88.9%, respectively.

Conclusion: GLS can effectively predict the presence of significant CAD in patients with NSTEMI and normal left ventricular systolic function on echocardiography.