The Behavior of Regional Longitudinal Strain Depends on Coronary Flow Reserve in a Simultaneous Analysis during Dipyridamole Stress Echocardiography

Background: The behavior of regional and global longitudinal strain in relation to the value of the coronary reserve is poorlystudied.Objectives: Compare the behavior of the Apical and global longitudinal Strain with the value of the coronary reserve of theanterior descending artery and as a secondary aim compare these responses with the visual analysis of parietal motility duringEcho Stress with Dipyridamole.Materials and methods: Retrospective study of 179 patients (age 68.7±7.8), 90 patients (50.3%) were men. At the peak of thedipyridamole effect, the coronary reserve was measured, simultaneously with the Longitudinal Strain and the visual analisis ofcontractility. Two groups were divided: Group 1: Coronary reserve ≥2 and Group 2: <2. Apical Strain was defined as the averageof 4 apical segments and global as the average of the 17 segments. It was considered normal any increased of deformationResults: 113 patients (63.12%) were included in Group 1 and 66 (36.87%) in Group 2. Strain Apical: 96.77% of Group 1 increasedtheir strain values with the stress, while in group 2, 95.31% presented a worsening strain values (p<0.0001). Global Strain:82.8% of Group 1 had an increase in their values, while in Group 2, 78.8% showed worsening (p<0.01). Post Dipyridamoleparietal Motility Analysis: 96.46% of Group 1 had preserved parietal motility and only 54.5% of Group 2 (4 patients hadincreased apical Strain in this group).Conclusions: There was a close correlation between the coronary reserve of the anterior descending artery and the contractilereserve evaluated by regional apical longitudinal strain of the 4 apical segments, which was superior to the use of globalstrain. The Apical Strain showed a better correlation with ADA coronary reserve than with the visual analysis of contractility.