Background
Coronary artery bypass grafting (CABG) remains associated with a non-neglectable major adverse cardiovascular and cerebrovascular events (MACCE) risk, and SYNTAX score is the most widely used tool to predict these events. However, transthoracic echocardiographic parameters are not included in SYNTAX score despite their crucial rule in evaluating cardiac structure and function. Therefore, the aim of this study was to evaluate the incremental value of transthoracic echocardiography in patients undergoing CABG by two-dimensional speckle-tracking echocardiography.
Method(s)
We collected all clinical and biological data required to calculate the SYNTAX score in patients hospitalized for coronary artery bypass grafting. Preoperative transthoracic echocardiography was performed for each patient. The endpoint was MACCE.
Result(s)
A total of 114 patients was included (mean age 61±8.3 years, 13% were women). The endpoint occurred in 24 patients (21%) and the median time to MACCE event was 51 months. Independent predictive factor for the endpoint was a decreased global longitudinal strain (GLS) (hazard ratio 1.106, 95% confidence interval 1.004-1.218; P = 0.041). Receiver operating characteristic curve showed the cutoff value of GLS was 15.24% with sensitivity 75% and specificity 60%. Kaplan–Meier survival analysis demonstrated patients with GLS <15.24% experienced higher cumulative incidence (P=0.012, Figure 1). Furthermore, area under the receiver operating characteristic curve was significantly improved after the integration of GLS with SYNTAX score (P=0.036, Figure 2).
Conclusion(s)
In patients undergoing CABG, left ventricular systolic function assessed by GLS should be performed systematically, as it may provide additional prognostic information to the SYNTAX score.

Incremental value of two-dimensional speckle-tracking echocardiography for cardiovascular and cerebrovascular events risk in patients undergoing coronary artery bypass surgery

ECHO ASIA is organized by Asian-Pacific Association of Echocardiography (AAE). The meeting combines the basic echocardiography training curriculum and the state-of-the-art lectures/scientific sessions provided by international as well as Asian-Pacific experts. The meeting is a unique forum where scientists from many countries in the Asian-Pacific region who are involved in the field of Doppler echocardiography gather together to exchange knowledge and skills. Various internationally distinguished faculties consent to present their findings and reveal their clinical experiences in ECHO ASIA.