Abstract

Background:Identification of significant coronary artery disease (CAD)in NSTEMI/UA/CSA patients without invasive methodsremains a clinical challenge. Severe CAD is known to cause LV dysfunction. However, the LV ejection fraction is usually normal at a relatively early stage. Therefore, establishing a more sensitive index for the detection of early-stage LV dysfunction is of utmost importance. Methods: This was a cross sectional observational study conducted on 136 patients with NSTEMI/UA/CSAto evaluate the value of global longitudinal strain (GLS) at rest to predict the presence of significant CAD and to determine the severity of CAD. The patients underwent transthoracic echocardiography (TTE) to measure 2D-STE to measure GLS. Results:Overall, Left Anterior Descending artery(43.38%) was the commonest vessel involved. Study revealed that mean GLS value was significantly lower in significant CAD (>70% stenosis)i.e. -15.95+ 2.78 than those with non-significant CAD (<70% stenosis) i.e. -20 + 1.73 with p < 0.001.The sensitivity and specificityfor SVD, DVD and TVD were67.53% andTVD were67.53% and 89.83%, 88.90% and 82.60%, 85.30% and 70.40% respectively. Conclusion:Global longitudinal strain (GLS) assessed by 2D speckle tracking echocardiography at rest has good sensitivity and specificity to predict the presence, extent and severity of CAD in patients.

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