PRELIMINARY FEASIBILITY OF STRESS MYOCARDIAL ELASTOGRAPHY FOR THE DETECTION OF CORONARY ARTERY DISEASE

Myocardial elastography (ME) is a cardiac strain imaging technique that has been found capable of detecting a decrease in radial strain caused by ischemia or infarction in patients with coronary artery disease (CAD) as well as in a canine model. Prior studies have focused on rest imaging, but stress testing can reveal func-tional deficits caused by stenoses that are asymptomatic at rest. Therefore, it has been proposed that stress ME (S-ME) improves the detection of CAD. A novel strain difference (As) metric is presented and investigated in a canine model of induced ischemia, as well as in a study in human patients with CAD validated by myocardial per-fusion imaging. In the canine model study, flow-limiting stenosis was induced by partial ligation in n = 2 canines, and stenosis was found to consistently reduce As in the affected myocardial regions compared with baseline, as well as compared to myocardial regions that are remote to the induced stenosis. In the clinical study, the median As was significantly lower (p < 0.05) in infarcted myocardial regions (-6.29%) than in those with normal perfu-sion (4.62%), with As in ischemic regions falling in between (-2.91%). The same trend was observed when con-sidering radial strain during stress and, to a lesser degree, at rest alone. The results indicate that S-ME may be more sensitive to mild cases of CAD that are functionally asymptomatic at rest. (E-mail: ek2191@columbia. edu)(c) 2022 World Federation for Ultrasound in Medicine & Biology. All rights reserved.