Development of a diagnostic model for severe coronary artery stenosis using resting echocardiography
10.3760/cma.j.cn131148-20250527-00293
- VernacularTitle:基于静息超声心动图构建冠状动脉重度狭窄诊断模型
- Author:
Qingyu ZHONG
1
;
Luwei YE
;
Lan SHANG
;
Sijia WANG
;
Hang WU
;
Zhenni ZHANG
;
Qingguo MENG
;
Chunmei LI
;
Yan DENG
;
Lixue YIN
;
Yi WANG
Author Information
1. 西南医科大学临床医学院，泸州 646000
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Severe coronary artery stenosis;
Left ventricular longitudinal layered strain;
Left atrial maximum volume
- From:
Chinese Journal of Ultrasonography
2025;34(11):958-966
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the diagnostic performance of resting echocardiography in detecting severe coronary artery stenosis.Methods:A total of 136 patients with suspected coronary artery disease（CAD）who presented to Sichuan Provincial People's Hospital between January 2021 and December 2024 were prospectively enrolled. All patients underwent both coronary computed tomography angiography（CCTA）and transthoracic echocardiography within one week. Based on CCTA results，the patients were divided into non-severe stenosis group（ n=78）and severe stenosis group（ n=58）. Echocardiographic parameters including left atrial maximum volume（LAVmax），left ventricular global longitudinal strain（GLS），left ventricular longitudinal strain of endo-myocardium，mid-myocardium，epi-myocardium（LSendo，LSmid，LSepi），early diastolic mitral inflow velocity（E），early diastolic mitral annular velocity of the lateral and septal walls（e'），and E/e' were measured. Predictive factors for severe coronary stenosis were identified using LASSO regression，and a nomogram model was developed via multivariate Logistic regression. Model performance was evaluated using ROC curves，calibration curves，and decision curve analysis. Results:Multivariate Logistic regression analysis revealed LSendo，LAVmax，and E/e' as independent predictors of severe coronary artery stenosis. The nomogram constructed based on these predictors achieved an area under the curve of 0.798（95% CI=0.723-0.873），with sensitivity and specificity of 0.756 and 0.759，respectively. Conclusions:The resting echocardiography-based nomogram model demonstrates good diagnostic efficacy for severe coronary artery stenosis. It may serve as a noninvasive tool to assist in risk stratification and clinical decision-making in patients with suspected CAD.
