Role of Speckle Tracking Echocardiography in Differentiating between Ischemic and Non-ischemic Cardiomyopathy

Abstract

Background and Aim: Cardiovascular imaging plays an essential role in the early detection of cardiac injury and left ventricular (LV) function subclinical alterations. Non-invasively, speckle-tracking imaging provides objective and quantitative assessment of global and regional cardiac function. We investigated whether speckle tracking echocardiography (STE) can be used to distinguish between ischemic cardiomyopathy (ICM) and non-ischemic dilated cardiomyopathy (NICM) based on the pattern of cardiac deformation. Materials and Methods: This research involved cases of dilated cardiomyopathy during the period from January 2022 to December 2022 in 100 patients separated into two groups. Baseline clinical data were evaluated. Conventional and STE were done. The cases were separated into two groups: Group A involved 50 cases with a history of ischemia confirmed by coronary angiography and group B involved 50 cases with NICM who had normal coronary angiography. Results: Patients with NICM had significantly greater LV volumes, lower LV systolic function, and lower global longitudinal and circumferential strain. Basal longitudinal strain over the sum of mid and apical longitudinal strain was significantly lower in NICM (0.42 ± 0.03 vs. 0.49 ± 0.03, P < 0.001). Moreover, regional longitudinal strain decreased from apical to basal in NICM and was homogeneous throughout all segments in ICM. Conclusion: Two-dimensional-STE can help differentiate ICM from NICM. Patients with NICM had a specific strain pattern as basal worsening of LV systolic strain with relative apical sparing.