ABC | Volume 110, Nº4, April 2018

Original Article Santos et al Applicability of LV S2DL in unstable UA Arq Bras Cardiol. 2018; 110(4):354-361 due to ischemia. We emphasize that in the study population, 56.1% had previous infarction and 44.6% had previous cardiac procedure (CTA, MRI or both). Shimoni et al., 18 evaluated SL2D in 97 hospitalized patients with angina and normal ventricular function; of these, 69 patients had major coronary disease. Global strain analysis was -17.3 ± 2.4 with an area under the ROC curve (AUC) of 0.80 to identify significant CAD in patients with angina; in the subgroup of patients with unstable angina the global strain also demonstrated good accuracy in predicting angiographic obstructive CAD (AUC = 0.86). 18 Findings of this study are similar to those found in relation to strain diagnostic accuracy to identify significant CAD in angina , however, there was no reference as to method applicability to the sample. We verified in the present study a statistically significant association between reduced global strain values and the presence of anatomically severe CAD, and similar accuracy to data available in the literature. 19 When we analyzed Figure 2 – ROC curve to evaluate ability of global strain to identify severe lesion (> 70%) in any epicardial coronary artery. Area under the ROC curve 0.875, with p < 0.014. 1.0 1.0 0.8 0.8 0.6 0.6 0.4 0.4 0.2 0.2 0.0 0.0 1 – Specificity ROC Curve Sensitivity Diagonal segments are produced by ties Figure 3 – Case of patient with unstable angina, anterior descending coronary artery with 90% lesion in the proximal third and circumflex coronary artery with lesion of 70% in the middle third. 359