Diagnostic Performance of Two-Dimensional Speckle Tracking
Echocardiography for Detection of Obstructive Coronary Artery Disease: A
Meta-Analysis.
Abstract
Background: Two-dimensional speckle tracking echocardiography (STE) is a
quantitative myocardial strain imaging technique in evaluating global
and segmental myocardial deformation. The aim of the meta-analysis was
to determine the diagnostic accuracy of STE in the detection of
significant coronary artery disease (CAD) in patients undergoing resting
or stress echocardiography. Methods: We performed a literature search in
PubMed and Medline until March 2020 for studies evaluating the role of
STE in diagnosing CAD. We assessed the diagnostic performance of STE in
detecting CAD by using the pooled estimate of sensitivity, specificity,
likelihood ratio, diagnostic odds ratio and diagnostic accuracy. We
analyzed longitudinal strain data that were reported in resting and
stress echocardiography. Results: A total of 17 studies (n=1762) were
included for the analysis. 12 studies (n=1239) reported global
longitudinal strain (GLS) in resting echocardiography and 5 studies
(n=523) reported GLS in stress echocardiography. Overall, in resting
echocardiography studies, pooled GLS sensitivity and specificity for
predicting obstructive CAD data were calculated to be 79% (95%
confidence interval 74-83%) and 77% (95% confidence interval
72-82%), respectively. The pooled odds ratio was 13.6 (95% confidence
interval 8.7-21.5). When we considered the dobutamine stress
echocardiograms alone, the sensitivity and specificity in predicting
obstructive CAD was 77% (95% confidence interval 59-89%) and 78%
(95% confidence interval 53-92%), respectively. The odds ratio was
12.6 (95% confidence interval 2.7-58.5). Conclusions: In this
meta-analysis of patients with suspected CAD, we found that STE could
effectively detect obstructive CAD with a high diagnostic sensitivity,
specificity and diagnostic accuracy