{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T22:53:49Z","timestamp":1785365629617,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"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":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Diagnosis of acute coronary syndrome (ACS) is often challenging especially in presence of initial normal troponins and non\u2010specific electrocardiogram. The index study aimed at determining the diagnostic value of strain echocardiography in patients with suspected ACS but with non\u2010diagnostic electrocardiogram and echocardiography findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was conducted on 42 patients with suspected ACS and non\u2010diagnostic electrocardiograms, normal quantitative troponin\u2010T levels, and left ventricular function. All patients underwent conventional and 2D\u2010strain echocardiography followed by coronary angiography, within 24\u00a0h of admission. Patients with regional wall motion abnormalities (RWMA), valvular heart disease, suspected myocarditis, and past coronary artery disease (CAD) were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Amongst the global strains, the global circumferential strain (GCS) was significantly reduced (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.014) amongst those with significant CAD on angiography as opposed to global longitudinal strain (GLS) which was similar in the two groups (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.33). The GCS\/GLS ratio was also significantly reduced in patients with significant CAD compared to those with normal\/mild disease on coronary angiography (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.025). Both the parameters had good accuracy in predicting significant CAD. GCS displayed a sensitivity of 80% and a specificity of 86% at an optimal cut\u2010off 31.5% (AUROC: .93, 95% CI: .601\u20131.000; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03), and likewise GCS\/GLS ratio had a sensitivity of 80% and a specificity and 86% at a cut\u2010off of 1.89% (AUROC: .86, 95% CI: .592\u20131.000; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.049). GLS and peak atrial longitudinal strain (PALS) did not differ significantly in patients with\/without significant CAD (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.32 and .58, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>GCS and GCS\/GLS ratio provides incremental value in comparison to GLS, PALS, and tissue Doppler indices (E\/e\u2019) in patients with suspected ACS and non\u2010diagnostic electrocardiogram and troponins. GCS at cut\u2010off of &gt;31.5% and GCS\/GLS ratio &gt;1.89 can reliably exclude patients with significant CAD in this setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15647","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T14:20:28Z","timestamp":1688739628000},"page":"802-809","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Role of two\u2010dimensional strain echocardiographic parameters in suspected acute coronary syndrome patients with initial non\u2010diagnostic electrocardiogram and troponins: An observational study"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7879-6262","authenticated-orcid":false,"given":"Rohit","family":"Tandon","sequence":"first","affiliation":[{"name":"Department of Cardiology Dayanand Medical College and Hospital (DMCH) Ludhiana 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of Cardiology Dayanand Medical College and Hospital (DMCH) Ludhiana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7606-5826","authenticated-orcid":false,"given":"Akash","family":"Batta","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dayanand Medical College and Hospital (DMCH) Ludhiana India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","first-page":"826","article-title":"Diagnostic role of echocardiography in patients admitted to the emergency room with suspect no\u2010ST\u2010segment elevation acute myocardial infarction","volume":"23","author":"Manfredonia L","year":"2019","journal-title":"Eur Rev Med Pharmacol 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