Correlation of Angiographic SYNTAX Score to Left Ventricular Global Longitudinal and Circumferential Strain

Background: Chronic myocardial ischemia results in left ventricular (LV) systolic dysfunction. The anatomical complex-ity of coronary artery disease (CAD) could be evaluated by the SYNTAX score. Aim of Study: This study aimed to correlate the SYNTAX score in patients undergoing elective coronary angiography to the LV global longitudinal strain (GLS) and global circumfer-ential strain (GCS) performed at rest by speckle-tracking echo-cardiography. Patients and Methods: This study included 60 patients scheduled for elective invasive coronary angiography after being diagnosed with CAD by a positive non-invasive test for myocardial ischemia. Speckle- tracking echocardiography was used to measure LV GLS and GCS. SYNTAX score I was used to evaluate the anatomical complexity of CAD after angiography. Results: Patients were divided into three groups based on the results of the coronary angiogram: Normal coronary an-giogram (n=12), low SYNTAX score (n=28, <22), and high SYNTAX score (n=20, ≥22). Baseline characteristics were comparable between the three groups. The high SYNTAX score group showed worse LV GLS and GCS (–16.90±2.17% and –19.70±1.59 respectively) in comparison to low SYNTAX score (–19.36±2.21, p<0.001 and –22.11±2.02, p<0.001 respec-tively) and normal SYNTAX score (–20.33±2.06, p<0.001 and –22.17± 1.90, p<0.001). There was a significant inverse cor-relation of SYNTAX score to LV GLS and LV GCS (r=0.458, p=0.0002, r=0.411, p=0.0011) respectively. Conclusion: LV GLS and LV GCS decline with the in-crease in CAD anatomical complexity measured by angio-graphic SYNTAX score.