{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:12:04Z","timestamp":1788336724679,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,11,5]],"date-time":"2018-11-05T00:00:00Z","timestamp":1541376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,12]]},"abstract":"Background<\/jats:title>Dipyridamole stress echocardiography (DSE<\/jats:styled-content>) represents a fundamental test in patients with suspected coronary artery disease (CAD<\/jats:styled-content>). The diagnosis of microvascular disease is still challenging. We aimed to determine the diagnostic value of left ventricular (LV<\/jats:styled-content>) layer\u2010specific longitudinal (LS<\/jats:styled-content>) and circumferential strain (CS<\/jats:styled-content>) by Speckle Tracking in detecting CAD<\/jats:styled-content> during DSE<\/jats:styled-content> and to study if they can help in discriminate between a negative echo and a suspected microvascular angina.<\/jats:p><\/jats:sec>Methods and results<\/jats:title>We enrolled 66 patients with known or suspected CAD<\/jats:styled-content>. All underwent standard DSE<\/jats:styled-content>. We identified 3 groups according to the result of DSE<\/jats:styled-content> (36 negative DSE<\/jats:styled-content>, 19 positive DSE<\/jats:styled-content>, 11 indicatives for microvascular disease). Wall motion score index, global LV LS<\/jats:styled-content> and CS<\/jats:styled-content> (global longitudinal strain [GLS<\/jats:styled-content>] and global circumferential strain [GCS<\/jats:styled-content>]), and layer\u2010specific LV LS<\/jats:styled-content> and CS<\/jats:styled-content> were measured at rest and peak stress. The Delta between rest and peak stress values was calculated. GLS<\/jats:styled-content> increased after injection in negative DSE<\/jats:styled-content> and microvascular disease while reducing in positive DSE<\/jats:styled-content>. Endocardial GCS<\/jats:styled-content> and transmural GCS<\/jats:styled-content> values were stable in microvascular disease while increasing significantly in negative DSE<\/jats:styled-content>, helping in the diagnosis. The specific analysis of endocardial LS<\/jats:styled-content> showed the most powerful difference between healthy and macrovascular CAD<\/jats:styled-content> patients, both for LS<\/jats:styled-content> and CS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Global circumferential strain can be a new valuable added tool in the echocardiographic diagnosis of microvascular disease. Endocardial GLS<\/jats:styled-content> is the best indicator of an altered wall deformation in the presence of macrovascular ischemia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14180","type":"journal-article","created":{"date-parts":[[2018,11,5]],"date-time":"2018-11-05T11:03:00Z","timestamp":1541415780000},"page":"2005-2013","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Layer\u2010specific strain in dipyridamole stress echo: A new tool for the diagnosis of microvascular angina"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-3006","authenticated-orcid":false,"given":"Giulia Elena","family":"Mandoli","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases University of Siena Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Cameli","sequence":"additional","affiliation":[{"name":"Department of 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