ArticleJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography2024
Global Longitudinal Strain as Predictor of Inducible Ischemia in No Obstructive Coronary Artery Disease in the CIAO-ISCHEMIA Study.
Article in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Myocardial strain shows modest diagnostic yield but may aid identification of patients with a low likelihood of ischemia during vasodilator stress cardiac magnetic resonance.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- The Biological Cost of Every Heartbeat: Imaging-Derived Cardiovascular Vulnerability in Infective Endocarditis.International journal of molecular sciences · 2026Article
- Global Longitudinal Strain in Stress Echocardiography: A Review of Its Diagnostic and Prognostic Role in Noninvasive Cardiac Assessment.Diagnostics (Basel, Switzerland) · 2025Review
- Adenosine stress myocardial perfusion imaging and myocardial work in evaluating INOCA.Scientific reports · 2025Article
- Association between the triglyceride-glucose index and subclinical left ventricular systolic dysfunction in obese patients.Cardiovascular diabetology · 2024Article
Corrections and comments
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Authors and funding
20 authors at 14 institutions in 4 countries.
Funding
Abstract
backgroundGlobal longitudinal strain (GLS) is a sensitive marker for identifying subclinical myocardial dysfunction in obstructive coronary artery disease (CAD). Little is known about the relationship between GLS and ischemia in patients with myocardial ischemia and no obstructive CAD (INOCA).
objectivesTo investigate the relationship between resting GLS and ischemia on stress echocardiography (SE) in patients with INOCA.
methodsLeft ventricular GLS was calculated offline on resting SE images at enrollment (n = 144) and 1-year follow-up (n = 120) in the CIAO-ISCHEMIA (Changes in Ischemia and Angina over One year in International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial screen failures with no obstructive CAD on computed tomography [CT] angiography) study, which enrolled participants with moderate or severe ischemia by local SE interpretation (≥3 segments with new or worsening wall motion abnormality and no obstructive (<50% stenosis) on coronary computed tomography angiography.
resultsGlobal longitudinal strain values were normal in 83.3% at enrollment and 94.2% at follow-up. Global longitudinal strain values were not associated with a positive SE at enrollment (GLS = -21.5% positive SE vs GLS = -19.9% negative SE, P = .443) or follow-up (GLS = -23.2% positive SE vs GLS = -23.1% negative SE, P = .859). Significant change in GLS was not associated with positive SE in follow-up (P = .401). Regional strain was not associated with colocalizing ischemia at enrollment or follow-up. Changes in GLS and number of ischemic segments from enrollment to follow-up showed a modest but not clinically meaningful correlation (β = 0.41; 95% CI, 0.16, 0.67; P = .002).
conclusionsIn this cohort of INOCA patients, resting GLS values were largely normal and did not associate with the presence, severity, or location of stress-induced ischemia. These findings may suggest the absence of subclinical myocardial dysfunction detectable by echocardiographic strain analysis at rest in INOCA.
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