Objective: Evaluation of the diagnostic value of speckle tracking echocardiography (STE) at rest and
during dobutamine stress in predicting the presence and severity of coronary artery disease (CAD) in
patients with chronic stable angina.
Methods: A total of 100 patients with chronic stable angina were evaluated using STE at rest and during
dobutamine stress to detect the presence, severity, and number of affected coronary arteries. Then, the
correlation with the SYNTAX score (SS) was analyzed.
Results: STE at stress showed better agreement with coronary angiography (CA) than dobutamine stress
echocardiography (DSE) in detecting the presence of coronary artery stenosis (Kappa ¼ 0.819, p < 0.001).
STE at stress suggested involvement of the left anterior descending artery (LAD) with excellent agreement
with CA (Kappa ¼ 0.816, p < 0.001). For right coronary artery, STE at rest and stress showed good
agreement with the CA results (Kappa ¼ 0.775 and 0.858, respectively, p < 0.001), whereas for left
circumflex artery, STE at rest and stress showed a fair agreement with the CA results (Kappa ¼ 0.556 and
0.583, respectively, p < 0.001). Resting global longitudinal peak systolic strain (GLPSS)  15.2% had the
best diagnostic accuracy (sensitivity ¼ 61.8%; specificity ¼ 93.5%) in predicting SS > 22. Stress
GLPSS  12.5% had the best diagnostic accuracy (sensitivity ¼ 82.4%; specificity ¼ 78.3%) in predicting
SS > 22.
Conclusion: Speckle tracking during DSE has high sensitivity and specificity for predicting the presence of
CAD. It provides quantitative diagnostic information that decreases the false positive and false negative
results of DSE.