LAUSR

BACKGROUND Coronary artery disease (CAD) severity prediction may be possible during dobutamine stress echocardiography (DSE) with various indices of the left ventricular (LV) function. AIMS We assessed the relative value of ejection fraction (EF), force, global longitudinal strain (GLS) and wall motion score index (WMSI) in predicting SYNTAX/ GENSINI scores in known or suspected CAD. METHODS We enrolled prospectively 223 patients (120 male; mean (SD) age 62 (9) years) and assessed: 1- EF (with triplane); 2- Force, calculated as the ratio between systolic blood pressure (SBP) and LV endsystolic volume (ESV); 3-GLS; 4- WMSI. All patients underwent coronary angiography within 12 weeks with SYNTAX and GENSINI evaluation. RESULTS The correlation of SYNTAX and GENSINI was highest with the peak WMSI (rho = 0.591 for SYNTAX and 0.612 for GENSINI, P < 0.001), intermediate with the peak Force (rho = -0.346 for SYNTAX and -0.377 for GENSINI, P < 0.001) and GLS (rho = -0.205, P = 0.002 for SYNTAX and -0.216 for GENSINI, P = 0.001) and the weakest for EF (rho = -0.149 for SYNTAX, P = 0.03 and -0.191, P = 0.006 for GENSINI). The similar hierarchy of variables was detected for changes during DSE whereas in the subgroup after myocardial infarction (MI) GLS outperformed the Force. CONCLUSIONS In CAD patients at DSE peak, the WMSI and Force predicted better the coronary SYNTAX/GENSINI score and CAD severity than GLS or EF. However, in patients after MI the GLS correlation with coronary scores improved and closed to visual assessment.