Abstract
Aim: The aim of this study was to evaluate changes in left ventricular function according to myocardial layer using speckle-tracking echocardiography (STE) in patients with ischemic heart disease. The study included 80 patients (47 males, 33 females) with a mean age of 68.69 ± 10.56 years, who underwent echocardiographic imaging using a Philips ultrasound system, capturing 2-, 3-, and 4-chamber views. Data were analyzed offline to assess myocardial strain in the epicardial, mid-myocardial, and endocardial layers, and to evaluate regional wall motion abnormalities in comparison with coronary angiography findings. Results: showed that both LS and GLS values in the epicardial layer were significantly lower than in the endocardial layer (p < 0.001); specifically, epicardial GLS was -11.74 ± 2.87, compared to -18.78 ± 3.95 in the endocardial layer. In patients with significant coronary artery stenosis (≥50%), epicardial STE demonstrated higher sensitivity and specificity than endocardial STE in detecting stenosis of the LAD, LCx, and RCA. Conclusion: Epicardial GLS is valuable for identifying significant coronary artery disease, with relatively high sensitivity and specificity when compared to digital subtraction coronary angiography.