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ORIGINAL ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 4  |  Page : 176-181

Sensitivity, specificity, and accuracy of left ventricular systolic function indices and structure in detecting early systolic dysfunction assessed by speckle-tracking two-dimensional strain: An echocardiographic cross-sectional study


1 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Paris, France
2 Department of Cardiovascular, Institute Mutualiste Montsouris, Paris, France
3 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1; Internal Medicine Service, Cardiology Unit, Yaounde Central Hospital, Paris, France
4 Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Paris, France; Internal Medicine Service, Cardiology Unit, Yaounde General Hospital, Yaounde, Cameroon

Correspondence Address:
Dr. Ahmadou Musa Jingi
Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1
France
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/rcm.rcm_18_18

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Background: Reduced global longitudinal strain (GLS) is an early marker of subclinical left ventricular (LV) dysfunction, permitting timely interventions to slow disease progression. This technique is not widely available in echocardiographs in routine use. Aim: We sought to know if LV systolic function indices and structural left heart changes could predict a reduced GLS. Methods: We carried out a cross-sectional analytic study in May 2017. We measured GLS (reference test), LV ejection fraction, LV midwall shortening (MWS), LV mass index, LV diastolic diameter, LV volumes, and left atrial volume (predictors). We calculated the sensitivity, specificity, accuracy, predictive values, and likelihood ratios of the predictor variables. We assessed the discriminatory power of the indices with the Youden Index and area under the receiver operator characteristic curve (AUC). Results: A total of 32 participants (14 males) were retained for this study. Their mean (standard deviation) age was 62 (15.3) years. Eccentric LV hypertrophy (LVH) was the most frequent LV geometric pattern – 14 (43.8%) participants. A reduced GLS was the most frequent LV functional anomaly – 20 (62.5%) participants. A low MWS <36.5% had a good predictive power of a reduced GLS – sensitivity: 80%, specificity: 83.2%, accuracy: 81.3%, and AUC: 0.817. The presence of LVH had a fair prediction power of reduced GLS – sensitivity: 70%, specificity: 81.8%, accuracy: 65.6%, and AUC: 0.741. The composite of MWS <36.5% and or LVH had a fair discriminatory power (AUC: 0.783, Youden Index: 0.567), with a good sensitivity – 90%. Conclusion: Low MWS of the LV and the presence of LVH were found to be good predictors of reduced GLS.


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