Ultrasound Evaluation of Left Ventricular Function in Coronary Artery Ectasia: The Added Value of 2D Speckle-tracking Echocardiography.

Introduction: Coronary artery ectasia (CAE) is defined as abnormal dilatation of coronary arteries and may be linked to subclinical myocardial dysfunction. Conventional echocardiographic parameters may not adequately detect early left ventricular (LV) dysfunction. Two-dimensional speckle-tracking echocardiography (2D STE) has shown promise in identifying subtle myocardial changes. Methods: In this single-center observational study, 90 participants with available coronary angiography were divided into three groups: Group A (controls, n = 30), Group B (single-vessel CAE, n = 30), and Group C (multi-vessel CAE, n = 30). Standard echocardiographic indices including LV ejection fraction (LVEF), volumes, and diastolic function were assessed. Global radial, longitudinal, circumferential, and area strains were measured using 2D STE. Univariate and post-hoc analyses compared measurements across groups. Results: LVEF was preserved in all groups (p = 0.157), with conventional echocardiography detecting abnormalities only in multi-vessel CAE (Group C). In contrast, 2D STE revealed subclinical dysfunction in both CAE groups. GLS declined from -20.4 % (controls) to -17.3 % (single-vessel) and -14.6 % (multi-vessel; p < 0.001). GCS and GRS followed similar patterns. Conclusions: 2D STE detected subclinical LV impairment in early CAE, whereas conventional methods revealed dysfunction only in advanced disease. This supports the value of 2D STE for early monitoring in CAE patients.