Algorithmic Approaches in Diagnostic Decision Support for Combined Use of Speckle-Tracking Echocardiography and Coronary Angiography in Patients with Coronary Artery Disease

Background. Improving methods of coronary artery disease (CAD) diagnosis involves determining the most informative and less expensive methods. Speckle tracking echocardiography (STE) is now widely used for early myocardial ischemia diagnosis, allowing better verification ambivalent results angiography (CAG).
 The aim. To develop algorithmic approaches to CAD through combined use STE CAG in order increase accuracy reduce cost treatment CAD.
 Methods. We examined 568 patients (425 [74.8%] men 143 [25.2%] women) aged 62.3±8.9 years admitted our center establishing indications interventions. All underwent directly before or after STE.
 Results. Through both no pathology was detected 5.2% 16.8% women. In 2.6% 4.2% women, found regional strain disorders absence significant alterations arteries (CA) according CAG. Such false-positive may witness of: 1) insignificant due congenital distal branches tortuosity intramural (I/M) CA course, as well microcirculation not diagnosed by CAG; 2) non-coronary dysfunction. 1.2% (up 50–70%) atherosclerotic stenotic lesions data suggestive longitudinal “drop” during STE. false-negative high reserve advanced collateral circulation viable myocardium ischemic area. Myocardial beds visualization CAG, characteristic decrease revealed STE, 91.1% 74.8% witnessing correlation obtained show coincidence signs hemodynamically stenoses methods, including I/M segments course.
 Conclusions. Combination with allows determination hemodynamic significance, a non-invasive imaging technique CAD, pharmacological stress test. Combined integrated analysis thereof identification circulatory that could be separately, helping diagnostic improve cost-effectiveness treatment.