However, cardiologists often face challenges when assessing atherosclerosis severity in non-acute settings. Specifically, recent findings suggest that Left Ventricular Strain CAD analysis via two-dimensional speckle tracking echocardiography (2D-STE) provides a robust non-invasive alternative. Consequently, this study investigated the relationship between myocardial strain parameters and the Gensini score. Therefore, researchers aimed to determine the predictive value of strain for coronary artery disease (CAD) severity and subclinical dysfunction.

Initially, the study enrolled 128 CAD patients and 32 healthy controls. Subsequently, they categorized patients into mild, moderate, and severe groups based on their Gensini scores. Notably, the results indicated that global longitudinal strain (GLS) and global circumferential strain (GCS) decreased significantly as coronary narrowing worsened. Furthermore, the correlation analysis showed strong positive links between these strain values and the Gensini score. In addition, twist and torsion parameters followed this same declining trend as myocardial mechanics deteriorated.

Implementing Left Ventricular Strain CAD Measurements

Because GLS demonstrated a strong correlation with disease burden, it serves as a primary marker for disease progression. Moreover, the study revealed that GLS possesses the highest predictive value for severe CAD among all echocardiographic parameters. Specifically, an area under the curve (AUC) of 0.829 underscores its diagnostic strength for identifying high-risk individuals. Indeed, these findings suggest that 2D-STE can reliably identify patients requiring urgent intervention. Consequently, using these metrics allows for better risk stratification in daily cardiology practice.

In contrast, standard parameters like ejection fraction often fail to detect early myocardial impairment. Instead, 2D-STE captures subtle changes in the subendocardial fibers. Finally, clinicians should integrate these tools into routine diagnostic workflows to improve patient care. Because this tool detects subclinical dysfunction early, it enhances the management of chronic coronary syndromes. Thus, physicians make more informed decisions regarding the necessity of angiography. Also, this approach minimizes procedural risks for patients with low-risk profiles.

Frequently Asked Questions

What is the clinical significance of the Gensini score?

The Gensini score is a numerical system used to quantify the severity of coronary artery disease based on the degree of luminal narrowing and the location of lesions identified during coronary angiography.

How does 2D-STE improve CAD diagnosis?

Two-dimensional speckle tracking echocardiography (2D-STE) provides a detailed assessment of myocardial deformation. It detects subclinical ventricular dysfunction even when traditional measures like ejection fraction appear normal.

Why is GLS considered a better predictor than GCS?

Global longitudinal strain (GLS) is highly sensitive to ischemia because it reflects the function of the subendocardial fibers, which are the most vulnerable to reduced coronary blood flow.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Lan WF et al. Study of the Relationship Between Left Ventricular Strain and the Gensini Score in Coronary Artery Disease by Two-Dimensional Speckle Tracking Echocardiography. J Clin Ultrasound. 2026 Mar 08. doi: 10.1002/jcu.70225. PMID: 41795285.

Marwick TH. The role of echocardiography in heart failure. JACC Cardiovasc Imaging. 2018;11(7):1011-1022.

Rampidis GP, et al. Gensini score: an overview. Hellenic J Cardiol. 2019;60(1):9-13.