Predictive Value Of Echocardiographic Epicardial Fat Thickness Combination With Two-dimension Longitudinal Strain For Coronary Artery Disease

Objective To explore the diagnostic and predictive value of echocardiographic epicardial adipose thickness( EAT) and the left ventricular longitudinal 2D strain at rest for coronary artey disease(CAD).Methods According to the results of coronary artery angiogram(CAG),106 consecutive patients with clinically suspected CAD were divided into two groups: CAD(n=60) and control group(n=46). EAT were measured by transthoracic echocardiography during end-systole(EATS) and end-diastole(EATD),respectively.Two-dimensional strain echocardiography was performed in the 3 apical projections of left ventricle(LV). Peak regional longitudinal systolic strain of LV was measured in 17 segments and averaged to provide global longitudinal peak systolic strain(GLS17), the average longitudinal peak systolic strain of 12 segments(GLS12,excluded the 5 apical segments). Drawing ROC curve,according to the maximal Youden index obtained the optimal predictive cutoff value of EATS and GLS12, analyzed the the area under the curve(AUC) of EATS, GLS12, combined indicator of EATS and GLS12,,compared the predictive value of the three methods.Results The EATS and EATD in CAD group was significantly higher than that in control group(both P<0.05). The EATS(OR=1.79)and GLS12(OR=1.20)were independent predictors of significant CAD(both P<0.05), the optimal cut-off value for the EATS and GLS12 was found to be 5.55 mm and- 16.9,respectively. AUC of EATS, GLS12 and the combined indicator were 0.67±0.05, 0.64±0.06 and 0.71±0.05,respectively, and the difference was statistically significant(P<0.05).Conclusions EATS and GLS12 may serve as an useful predictive marker of CAD separately,while combining the two indicator, the predictive performance of is significantly improved.